Current status of robotic thyroidectomy and neck dissection using a gasless transaxillary approach.

PURPOSE OF REVIEW: To describe refinements in surgical techniques using robotic thyroidectomy and robotic modified radical neck dissection (MRND), and to discuss the impact of such developments on thyroid cancer management, from oncological, functional, and surgical viewpoints.

RECENT FINDINGS: From 2009 to present, 23 reports, including three multicenter trials, on the conduct of robotic thyroid surgery via a gasless transaxillary approach appeared. Twenty-two studies discussed robotic thyroidectomy, whereas one described robotic MRND. These clinical studies showed that robotic surgery afforded identical or superior levels of surgical radicality and oncologic safety compared to use of conventional open or endoscopic surgery in patients with thyroid carcinomas. In such patients, the clinical benefits of robotic thyroidectomy include excellent cosmetic results, reduced pain, improvement in swallowing function, and low morbidity rates. From the viewpoint of surgeons, robotic surgery shortens the surgical learning curve, and causes less musculoskeletal discomfort compared with the conduct of open or endoscopic surgery.

SUMMARY: The accumulated evidence to date suggests that robotic thyroidectomy and MRND can benefit both patients and surgeons.