Robotic Transaxillary Thyroidectomy - A minimally invasive cervical approach
Autores
Mariana Mourão, Sofia Cuco Guerreiro, Barbara Mullineris , Paula Tavares, Micaela Piccoli, Hugo Pinto Marques
Resumo Introdução
Minimally invasive surgery (MIS) is constantly developing, including thyroid surgery. Robotic thyroidectomy by transaxillary approach (RATS) is a safe alternative for selected patients with benign disease or low risk thyroid cancer. We present a Robotic Transaxially Thyroidectomy, discuss its advantages and disadvantages and the challenges associated.
Resumo Métodos
A 61-year-old women with a 15x9mm left isthmic thyroid nodule, with regular margins and no microcalcifications, with a Fine-needle aspiration cytology revealing a follicular neoplasm is proposed for RATS.
Resumo Resultados
The patient undergoes a hybrid, robotic assisted, left thyroidectomy, with the use of the Modena Retractor, Intraoperative Neuro-Monitoring and Indocyanine Green vascular test, thanks to the integration of the firefly technology in the Da Vinci X robotic system. With an intra-operative time of 3 hours, 20 cc of blood loss and no complications. She was discharged 36 hours after the procedure.
Resumo Discussão
The robotic technology offers an image enhanced perspective of the cervical structures, allows for more precise movements and minimal dissection. With the incorporation of other helps guarantee the safety of the procedure. There is minimal post-operative pain and no visible cervical scar. It is, however, associated with an important learning curve, particularly for the endoscopic part and increased cost when compared with other approaches. MIS is the future of thyroid and cervical surgery, with robotics having an important role to play.