The evolution and clinical impact of single-port transaxillary robotic thyroidectomy: a comprehensive review

Abstract

Single-port (SP) transaxillary robotic thyroidectomy represents a significant innovation in the field of endocrine surgery, offering a minimally invasive approach that combines oncological efficacy with enhanced cosmetic outcomes. The introduction of the SP robotic system has enabled surgeons to perform thyroidectomy and lateral neck dissection through a single axillary incision, resulting in a scarless neck and reduced postoperative morbidity. This review explores the current practices and surgical techniques associated with SP transaxillary robotic thyroidectomy, emphasizing the benefits of the SP robotic system over traditional multi-port and open approaches. The system's enhanced precision, due to its articulated instruments and high-definition three-dimensional visualization, allows for meticulous dissection, minimizing the risk of complications such as recurrent laryngeal nerve injury and hypocalcemia. The SP design simplifies the surgical process, reducing trauma to surrounding tissues and leading to faster recovery times and improved patient satisfaction. Clinical outcomes of the SP approach are promising, with studies indicating comparable oncological safety to conventional methods and superior cosmetic results. Patient satisfaction is notably high, particularly regarding the absence of visible neck scarring. However, the technique's adoption is limited by its steep learning curve and the high cost of the SP robotic system. This review also highlights the need for further long-term studies to fully assess the sustainability of the SP robotic system's benefits, especially in terms of oncological outcomes and cost-effectiveness. The potential of the SP transaxillary approach to become a standard option in thyroid surgery is discussed, alongside the importance of continued research and surgeon training to optimize its use. In conclusion, SP transaxillary robotic thyroidectomy offers a compelling alternative to traditional approaches, with the potential to significantly enhance patient outcomes and satisfaction in thyroid surgery.