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Retroauricular Robotic Thyroid Surgery with DaVinci Xi System Overcoming the Limitation with DaVinci Si System
Dept.of Otorhinolaryngology, Severance Hosp., Yonsei Univ. College of Medicine1,Dept. of Otorhinolaryngology, Soonchunhyang Univ.College of Medicine 2,King Chulalongkorn Memorial Hosp. Thai Red Cross Society, Dept. of Otolaryngology, Faculty of Medicine, Chulalongkorn Univ.3,Division of Head and Neck Surgery, Dept. of Otolaryngology, Stanford Univ. 4
Myung Jin BAN, Myung Jin BAN1,Jae Won CHANG1,Jae Hong PARK2,Byung Il CHOI1,Jin Won KIM1,Da Hee KIM1,Won Shick KIM1,Tangjaturonrasme NAPADON3,F. Christopher HOLSINGER4,Yoon Woo KOH1,Se-Heon KIM1,Eun Chang CHOI1
¸ñÀû: We previously reported the feasibility of retroauricular thyroidectomy with DaVinci Si. However, only two robotic arms could be introduced through retroauricular port due to some mechanical limitations. Recently, Robotic retroauricular thyroidectomy is being performed with three arms of DaVinci Xi system. We intended to evaluate early experiences of DaVinci Xi retroauricular thyroidectomy with three arms. ¹æ¹ý:After cadaver study on feasibility and safety, 5 cases of DaVinci Xi retroauricular thyroidectomy were performed. Three robotic arms(monopolar spatula, Bipolar forceps, and ProGrasp) with 3D endoscope were placed through retroauricular port immediately after elevating the skin flap. Creating working space and thyroidectomy could be performed with robotic system under console works. ERBE system were used as an energy device. °á°ú:We completed 5 cases of DaVinci Xi hemithyroidectomy. Three cases were right sided and female. Mean age was 46.2 years. Two cases were papillary thyroid carcinoma and 3 were follicular adenoma or adenomatous hyperplasia. Mean maximum tumor diameter and gland size were 2.12 (0.7-4.3)cm and 5.04 (4.2-5.4)cm. Mean time for skin flap elevation for thyroidectomy 31.8min, robotic arms docking for thyroidectomy 11.2min, console time for hemi thyroidectomy 113min. Average blood loss was 32cc, hosital stay were 6days. Entire surgeries could be performed using three robotic arms with minimal assistance. All operations were successful with no serious intraoperative complications. Recurrent laryngeal nerve injury and perioperative bleeding were not developed. °á·Ð: Real solo robotic thyroidectomy could be achieved with DaVinci Xi. This system is more optimized for robotic thyroidectomy via a retroauricular approach than previous one.


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