Differences between 2 Robotic Thyroidectomy Techniques

Objective Two distinct remote access robotic thyroidectomy techniques were implemented in a high‐volume endocrine surgery practice. Important technical and clinical differences were observed and are described. Method Demographic and clinical parameters were prospectively captured in a series of patients undergoing 1 of 2 robotic thyroidectomy techniques (robotic axillary thyroidectomy [RAT] or robotic facelift thyroidectomy [RFT]). Attention was paid to time of surgery, ease of dissection, complications, use of drains, and length of stay. Results Fifteen robotic hemithyroidectomies were accomplished by either RAT (n = 5) or RFT (n = 10). The duration of surgery for the 5 RATs averaged 196 ± 38.1 minutes, with no clear downward trend observed; time of surgery for RFT was 156.9 ± 16.3 minutes with a steady trend towards shorter surgical times. All 5 RAT patients were managed with drains and on an inpatient basis (LOS = 1.0 days); 9 of 10 RFT patients were managed without drains and on an outpatient basis. Ease of surgery, familiarity with anatomic dissection planes, and surgeon comfort level all favored RFT. Conclusion In the implementation phase, a more rapid learning curve, reflected by shorter operative times, was observed with RFT compared with RAT. Furthermore, the vast majority of patients could be managed as outpatients even early in the experience, which represents one of several apparent advantages.