ABSTRACT
BACKGROUND: Recently, robotic surgery has been introduced as a new surgical approach to the thyroid. OBJECTIVES: The primary objective of this systematic review is to critically examine safety and feasibility of the different robotic approaches. METHODS: The literature on robotic thyroidectomy was systematically reviewed. Primary endpoints were surgery duration, length of hospital stay, complications, postoperative pain and cosmetic satisfaction. RESULTS: Sixty-eight studies with a total of 14433 patients were included. Depending on the robotic approach used, operative duration ranged between 89 and 230 min and hospitalisation stay between 0.1 and 5.6 days. Complication rates varied between 7.3% and 29%. Postoperative pain visual analogue scores (VAS) ranged from 0.6 to 4.71. CONCLUSION: Robotic thyroidectomy results in high cosmetic satisfaction and quality of life. No differences in complication rates between robotic and traditional approaches are observed, supporting safety and feasibility of these robotic techniques.
Subject(s)
Robotic Surgical Procedures , Robotics , Thyroid Neoplasms , Humans , Thyroidectomy/methods , Robotic Surgical Procedures/methods , Thyroid Neoplasms/surgery , Quality of Life , Robotics/methods , Operative Time , Postoperative Complications , Treatment OutcomeABSTRACT
BACKGROUND: The da Vinci Xi system is not Food and Drug Administration approved for transoral robotic surgery (TORS), resulting in limited data. METHODS: This prospective study evaluates the feasibility, safety, and outcomes of Xi-TORS in an oncological setting. RESULTS: Sixty-one patients with head and neck cancer were consecutively included for Xi-TORS. Adequate exposure and macroscopically complete resection were achieved in 59 patients (success rate = 96.7%). Intraoperative difficulties and complications were encountered in 47.5% and 20.3% of patients, respectively. Postoperative hemorrhage occurred in 11.9%; no treatment-related deaths were encountered. Two-year overall survival and disease-specific survival were 90.5% and 95.6%, respectively. No long-term (>1 month) tracheotomies were necessary, and only two patients remained tube-feeding dependent. The functional baseline level was regained at 12 months for the MD Anderson Dysphagia Inventory and at 24 months for the Swallowing quality-of-life questionnaire. QLQ-H&N35-assessed QOL returned to baseline 6 months postoperatively. CONCLUSIONS: Xi-TORS is safe, feasible, and with high oncological and functional effectiveness.