Present and future of robot-assisted endoscopic thyroid surgery.

OBJECTIVE: Robot-assisted endoscopic surgery has been increasingly accepted because of its unique three-dimensional vision and precise simulation-based technology. However, the utilization of robotic systems in thyroid surgery is limited. We conducted a systematic review to assess the application and development of robot-assisted endoscopic surgical technique in thyroid surgery.

DATA SOURCES: Articles published in PubMed before June, 2011 about robot-assisted endoscopic surgery were selected.

STUDY SELECTION: Original articles and critical reviews selected were related to robot-assisted (thyroid) surgery or endoscopic thyroid surgery, and a total of 3540 relevant articles were retrieved and 34 were finally cited.

RESULTS: Robot-assisted operation of benign thyroid diseases were successfully performed, although the operation time is too long to exhibit its advantages. Nevertheless, the superiority of robot-assisted endoscopic surgical technique compared to conventional endoscopic surgery in the treatment of thyroid carcinoma were obvious, since robotic radical thyroidectomy with central and lateral neck lymph node dissection could be achieved while maintaining operative results and cosmetic outcomes equivalent to or better than conventional endoscopic surgery. Furthermore, the learning curve duration of robot-assisted endoscopic thyroid surgery was shorter than that of conventional endoscopy, especially for the novices without any endoscopic surgical basis.

CONCLUSION: Robot-assisted endoscopic thyroid surgery, with its safety, feasibility, thoroughness, cosmetic benefits, and ability to overcome the limitations of conventional endoscopic surgery, will be further improved and applied, and is worthy of attention.