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Review
. 2015 Oct;4(5):429-34.
doi: 10.3978/j.issn.2227-684X.2015.02.02.

Transoral robotic thyroid surgery

James H Clark  1 , Hoon Yub Kim  1 , Jeremy D Richmon  1
Affiliations
Review

Transoral robotic thyroid surgery

James H Clark et al. Gland Surg. 2015 Oct.

Abstract

There is currently significant demand for minimally invasive thyroid surgery; however the majority of proposed surgical approaches necessitate a compromise between minimal tissue dissection with a visible cervical scar or extensive tissue dissection with a remote, hidden scar. The development of transoral endoscopic thyroid surgery however provides an approach which is truly minimally invasive, as it conceals the incision within the oral cavity without significantly increasing the amount of required dissection. The transoral endoscopic approach however presents multiple technical challenges, which could be overcome with the incorporation of a robotic operating system. This manuscript summarizes the literature on the feasibility and current clinical experience with transoral robotic thyroid surgery.

Keywords: Transoral; endoscopic; minimally invasive; robotic; thyroid surgery; thyroidectomy.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Cadaver with three robotic ports placed anterior to the mandible to access the central neck.
Figure 2
Figure 2
The robot docked with the three ports placed through the vestibule anterior to the mandible. The central camera port enters between the fasciculus of the mentalis muscles.
Figure 3
Figure 3
View through the console of the right recurrent laryngeal nerve after a central neck dissection has been performed.
Figure 4
Figure 4
An external incision was made after the transoral robotic thyroidectomy to demonstrate the completeness of the thyroidectomy, nerve dissection, and central neck dissection.
Figure 5
Figure 5
Port placement of robotic transoral periosteal thyroidectomy using three ports; (A) lateral and (B) anterior views. Three robotic arms were placed through the transoral ports.
Figure 6
Figure 6
View during the robotic transoral periosteal thyroidectomy using three ports; (A) lateral and (B) anterior views. Three robotic arms were placed through the transoral ports. The da Vinci robotic system was docked at the patient’s left side. The robotic camera was inserted through the central port.
Figure 7
Figure 7
(A) The incision scar of the patient undergone robotic transoral periosteal thyroidectomy (TOPOT) (postoperative 1st day); (B) the incision scar of the patient is almost imperceptible (postoperative 2nd week).
See this image and copyright information in PMC

References

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    1. Richmon JD, Pattani KM, Benhidjeb T, et al. Transoral robotic-assisted thyroidectomy: a preclinical feasibility study in 2 cadavers. Head Neck 2011;33:330-3. - PubMed
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