Robotic‐Assisted Thyroidectomy: The First UK Experience

摘要

Objective To review our initial experience of robotic thyroidectomy, describe modifications for a Western population, and establish a robust framework for implementation in the UK. Method Prospective feasibility study (n = 15) performed in a tertiary referral center over 18 months. Procedure‐related measures included conversions to open, operative time and the learning curve. Patient‐related measures included biometrics, trans‐axillary dissection area, voice and swallow function, pain, scar cosmesis, and global quality of life using validated assessment tools. Results Thyroid lobectomy was performed in 15 patients with no conversions to open. The average BMI was 25.6 (range, 19‐35). Mean operative time was 200 minutes. A larger trans‐axillary dissection area increased the total operative time. The average size of the excised nodule was 2.5 cm (range, 1.5‐6.5 cm). All patients were discharged within 24 hours. No permanent complications occurred. There was 1 temporary brachial plexus neuropraxia which resolved within 5 days. The mean follow‐up time was 7 months. The mean scar cosmesis score significantly improved from 56% on day 1 postoperatively to 98% at 12 months ( P =. 01). Conclusion Robotic thyroidectomy is feasible for selected patients in the UK. The primary advantage is avoidance of a neck scar. Optimal arm position which minimizes brachial plexus injury is crucial. Validated training methods are necessary for safe adoption. A randomized clinical study will establish the clinical efficacy compared with conventional surgery.