Transoral Thyroidectomy Using A Flexible Robotic System: A Preclinical Cadaver Feasibility Study

Elizabeth E. Cottrill, Emily K. Funk, David Goldenberg, Neerav Goyal

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives/Hypothesis: Traditionally, most thyroid surgery utilizes a curvilinear cervical incision with a resulting permanent scar. Minimally invasive and remote access thyroid surgery techniques continue to evolve. Transoral approaches through a vestibular incision have been developed at several centers throughout the world, obviating the need for a cutaneous incision and optimizing aesthetics. To date this technique has been performed using rigid endoscopes or a linear robotic platform. The goal of this study was to test the feasibility of a novel flexible robotic system to perform a transvestibular thyroidectomy in a preclinical cadaver model. Study Design: Preclinical feasibility study. Methods: Right and left thyroid lobectomies were successfully performed via a transvestibular approach in four cadavers. Results: A single vestibular incision between bilateral mental nerves allowed entrance of the flexible robot in a subplatysmal plane in both male and female cadavers. The recurrent laryngeal nerves and parathyroids were identified and preserved. The flexible three-dimensional camera allowed excellent visualization and could be easily repositioned for optimal visualization of right and left structures. The flexible and wristed instruments enabled an atraumatic approach and allowed for precise surgical technique. Conclusions: The transoral vestibular approach to the central neck is a promising technique for thyroidectomy with optimal cosmesis and can be successfully accomplished using this novel flexible robotic system. Improvements in visualization and access offered by this system may improve application of this technique. Level of Evidence: NA. Laryngoscope, 129:1482–1487, 2019.

Original languageEnglish (US)
Pages (from-to)1482-1487
Number of pages6
JournalLaryngoscope
Volume129
Issue number6
DOIs
StatePublished - Jun 1 2019

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Thyroidectomy
Feasibility Studies
Robotics
Cadaver
Thyroid Gland
Recurrent Laryngeal Nerve
Laryngoscopes
Endoscopes
Esthetics
Cicatrix
Neck
Skin

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology

Cite this

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abstract = "Objectives/Hypothesis: Traditionally, most thyroid surgery utilizes a curvilinear cervical incision with a resulting permanent scar. Minimally invasive and remote access thyroid surgery techniques continue to evolve. Transoral approaches through a vestibular incision have been developed at several centers throughout the world, obviating the need for a cutaneous incision and optimizing aesthetics. To date this technique has been performed using rigid endoscopes or a linear robotic platform. The goal of this study was to test the feasibility of a novel flexible robotic system to perform a transvestibular thyroidectomy in a preclinical cadaver model. Study Design: Preclinical feasibility study. Methods: Right and left thyroid lobectomies were successfully performed via a transvestibular approach in four cadavers. Results: A single vestibular incision between bilateral mental nerves allowed entrance of the flexible robot in a subplatysmal plane in both male and female cadavers. The recurrent laryngeal nerves and parathyroids were identified and preserved. The flexible three-dimensional camera allowed excellent visualization and could be easily repositioned for optimal visualization of right and left structures. The flexible and wristed instruments enabled an atraumatic approach and allowed for precise surgical technique. Conclusions: The transoral vestibular approach to the central neck is a promising technique for thyroidectomy with optimal cosmesis and can be successfully accomplished using this novel flexible robotic system. Improvements in visualization and access offered by this system may improve application of this technique. Level of Evidence: NA. Laryngoscope, 129:1482–1487, 2019.",
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Transoral Thyroidectomy Using A Flexible Robotic System : A Preclinical Cadaver Feasibility Study. / Cottrill, Elizabeth E.; Funk, Emily K.; Goldenberg, David; Goyal, Neerav.

In: Laryngoscope, Vol. 129, No. 6, 01.06.2019, p. 1482-1487.

Research output: Contribution to journalArticle

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