Surgical Outcomes of Transaxillary Robotic Thyroidectomy for Graves’ Disease: Comparison of Single-incision and Double-incision

Eun Jeong Ban, Min Jhi Kim, JungBum Choi, Taehyung Kim, Seul Gi Lee, Cho Rok Lee, Sang Wook Kang, Jandee Lee, Jong Ju Jeong, Kee-Hyun Nam, Woong Youn Chung, Cheong Soo Park. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

Background: This report details our experience with single-incision transaxillary robotic thyroidectomy (SITRT) for Graves' disease and provides a comparison to double-incision transaxillary robotic thyroidectomy (DITRT).

Methods: From June 2009 to June 2015, 26 patients who underwent transaxillary robotic thyroidectomy for Graves' disease were reviewed retrospectively. These patients included 18 individuals who underwent SITRT and 8 who underwent DITRT. The clinical characteristics and surgical outcomes of the 2 groups were compared.

Results: The mean total operative time was 101.0 (88-114) minutes for the SITRT and 158.5 (126-191) minutes for DITRT (P=0.598). The mean weight of the resected glands was 91.5 (60-123) g for the SITRT and 76 (33-119) g for DITRT (P=0.468). The estimated blood loss was 17.5 (10-150) mL for SITRT and 100 (5-140) mL for DITRT (P=0.911). There was no significant difference in terms of preoperative thyroid function test and operation extent, hospitalization period, and postoperative complications between two groups. There was no conversion to open surgery. During a mean follow-up period of 14.78 ± 9.29 months for SITRT, no patients continued antithyroid drugs or developed recurrent GD. All patients who underwent SITRT were satisfied with the cosmetic outcomes.

Conclusion: Relative to DITRT, SITRT provides improved surgical outcomes with superior cosmesis. In comparison to DITRT, SITRT is safe and feasible in the hands of an experienced robotic surgeon.