Robotic facelift thyroidectomy

Patient selection and technical considerations

David J Terris, Michael C. Singer, Melanie W. Seybt

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Objectives: A series of remote access thyroidectomy techniques, some using a surgical robot, have been introduced in the last decade. Most of these approaches require awkward positioning, use unfamiliar dissection planes, and have been associated with a number of significant complications. As a result, acceptance has been limited. We describe technical details and patient selection criteria of a recently described robotic facelift thyroidectomy (RFT) approach that avoids these pitfalls. DESIGN: Analysis of preclinical and clinical studies. Methods: Inanimate and cadaver dissection studies and clinical implementation were pursued. A 3-arm RFT technique with a 30-degree offset base location proved optimal. Supine positioning with arms tucked and the patient in slight Trendelenburg position facilitated the dissection of the optical pocket. Demographic and surgical data that have been obtained and considered include patient age, sex, body mass index, pathology, and complications. Results: A series of consecutive RFT procedures has been accomplished in a limited population of patients. All cases were completed robotically with no conversions to open surgery necessary. All but the first case was accomplished on a drainless, outpatient basis. Conclusions: A RFT technique that is gasless and uses a single access port in the postauricular crease and occipital hairline location is feasible, technically less challenging than other remote access methods, and safe. Further study in an expanded patient population and in additional high-volume thyroid centers is warranted. See the videos, Supplemental Digital Content 1, http://links.lww.com/SLE/ A36andSupplementalDigitalContent2, http://links.lww.com/SLE/A37.

Original languageEnglish (US)
Pages (from-to)237-242
Number of pages6
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Volume21
Issue number4
DOIs
StatePublished - Aug 1 2011

Fingerprint

Rhytidoplasty
Thyroidectomy
Robotics
Patient Selection
Dissection
Head-Down Tilt
Conversion to Open Surgery
Cadaver
Population
Thyroid Gland
Body Mass Index
Outpatients
Demography
Pathology

Keywords

  • cosmetic
  • endoscopic
  • minimally invasive
  • outpatient
  • robotic
  • thyroidectomy

ASJC Scopus subject areas

  • Surgery

Cite this

Robotic facelift thyroidectomy : Patient selection and technical considerations. / Terris, David J; Singer, Michael C.; Seybt, Melanie W.

In: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, Vol. 21, No. 4, 01.08.2011, p. 237-242.

Research output: Contribution to journalArticle

@article{08a18e59b152416bbe9bb1fe2367e947,
title = "Robotic facelift thyroidectomy: Patient selection and technical considerations",
abstract = "Objectives: A series of remote access thyroidectomy techniques, some using a surgical robot, have been introduced in the last decade. Most of these approaches require awkward positioning, use unfamiliar dissection planes, and have been associated with a number of significant complications. As a result, acceptance has been limited. We describe technical details and patient selection criteria of a recently described robotic facelift thyroidectomy (RFT) approach that avoids these pitfalls. DESIGN: Analysis of preclinical and clinical studies. Methods: Inanimate and cadaver dissection studies and clinical implementation were pursued. A 3-arm RFT technique with a 30-degree offset base location proved optimal. Supine positioning with arms tucked and the patient in slight Trendelenburg position facilitated the dissection of the optical pocket. Demographic and surgical data that have been obtained and considered include patient age, sex, body mass index, pathology, and complications. Results: A series of consecutive RFT procedures has been accomplished in a limited population of patients. All cases were completed robotically with no conversions to open surgery necessary. All but the first case was accomplished on a drainless, outpatient basis. Conclusions: A RFT technique that is gasless and uses a single access port in the postauricular crease and occipital hairline location is feasible, technically less challenging than other remote access methods, and safe. Further study in an expanded patient population and in additional high-volume thyroid centers is warranted. See the videos, Supplemental Digital Content 1, http://links.lww.com/SLE/ A36andSupplementalDigitalContent2, http://links.lww.com/SLE/A37.",
keywords = "cosmetic, endoscopic, minimally invasive, outpatient, robotic, thyroidectomy",
author = "Terris, {David J} and Singer, {Michael C.} and Seybt, {Melanie W.}",
year = "2011",
month = "8",
day = "1",
doi = "10.1097/SLE.0b013e3182266dd6",
language = "English (US)",
volume = "21",
pages = "237--242",
journal = "Surgical Laparoscopy, Endoscopy and Percutaneous Techniques",
issn = "1530-4515",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Robotic facelift thyroidectomy

T2 - Patient selection and technical considerations

AU - Terris, David J

AU - Singer, Michael C.

AU - Seybt, Melanie W.

PY - 2011/8/1

Y1 - 2011/8/1

N2 - Objectives: A series of remote access thyroidectomy techniques, some using a surgical robot, have been introduced in the last decade. Most of these approaches require awkward positioning, use unfamiliar dissection planes, and have been associated with a number of significant complications. As a result, acceptance has been limited. We describe technical details and patient selection criteria of a recently described robotic facelift thyroidectomy (RFT) approach that avoids these pitfalls. DESIGN: Analysis of preclinical and clinical studies. Methods: Inanimate and cadaver dissection studies and clinical implementation were pursued. A 3-arm RFT technique with a 30-degree offset base location proved optimal. Supine positioning with arms tucked and the patient in slight Trendelenburg position facilitated the dissection of the optical pocket. Demographic and surgical data that have been obtained and considered include patient age, sex, body mass index, pathology, and complications. Results: A series of consecutive RFT procedures has been accomplished in a limited population of patients. All cases were completed robotically with no conversions to open surgery necessary. All but the first case was accomplished on a drainless, outpatient basis. Conclusions: A RFT technique that is gasless and uses a single access port in the postauricular crease and occipital hairline location is feasible, technically less challenging than other remote access methods, and safe. Further study in an expanded patient population and in additional high-volume thyroid centers is warranted. See the videos, Supplemental Digital Content 1, http://links.lww.com/SLE/ A36andSupplementalDigitalContent2, http://links.lww.com/SLE/A37.

AB - Objectives: A series of remote access thyroidectomy techniques, some using a surgical robot, have been introduced in the last decade. Most of these approaches require awkward positioning, use unfamiliar dissection planes, and have been associated with a number of significant complications. As a result, acceptance has been limited. We describe technical details and patient selection criteria of a recently described robotic facelift thyroidectomy (RFT) approach that avoids these pitfalls. DESIGN: Analysis of preclinical and clinical studies. Methods: Inanimate and cadaver dissection studies and clinical implementation were pursued. A 3-arm RFT technique with a 30-degree offset base location proved optimal. Supine positioning with arms tucked and the patient in slight Trendelenburg position facilitated the dissection of the optical pocket. Demographic and surgical data that have been obtained and considered include patient age, sex, body mass index, pathology, and complications. Results: A series of consecutive RFT procedures has been accomplished in a limited population of patients. All cases were completed robotically with no conversions to open surgery necessary. All but the first case was accomplished on a drainless, outpatient basis. Conclusions: A RFT technique that is gasless and uses a single access port in the postauricular crease and occipital hairline location is feasible, technically less challenging than other remote access methods, and safe. Further study in an expanded patient population and in additional high-volume thyroid centers is warranted. See the videos, Supplemental Digital Content 1, http://links.lww.com/SLE/ A36andSupplementalDigitalContent2, http://links.lww.com/SLE/A37.

KW - cosmetic

KW - endoscopic

KW - minimally invasive

KW - outpatient

KW - robotic

KW - thyroidectomy

UR - http://www.scopus.com/inward/record.url?scp=80052219725&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052219725&partnerID=8YFLogxK

U2 - 10.1097/SLE.0b013e3182266dd6

DO - 10.1097/SLE.0b013e3182266dd6

M3 - Article

VL - 21

SP - 237

EP - 242

JO - Surgical Laparoscopy, Endoscopy and Percutaneous Techniques

JF - Surgical Laparoscopy, Endoscopy and Percutaneous Techniques

SN - 1530-4515

IS - 4

ER -