Transoral Robotic Thyroidectomy

Abstract

Introduction: The primary goal of remote-access thyroid surgery is to avoid a visible cervical scar. There have been numerous approaches to achieve this with both endoscopic and robotic techniques. We present a video of our early experience with transoral robotic thyroidectomy. Materials and Methods: Transoral robotic thyroidectomy was performed on five patients at Johns Hopkins Hospital. A representative procedure is demonstrated in this video. Results: Five women between the ages of 17 and 65 consented to undergo the procedure. One patient required conversion to an open approach because of a large substernal goiter that was not appreciated on the preoperative ultrasonography. The remaining patients all underwent lobectomies successfully. The recurrent laryngeal nerve was preserved in all patients. No drains were required. All patients had benign pathology. The average nodule size was 2.5 cm and average thyroid lobe volume was 31 cc. All patients had intact, although decreased, lower lip sensation postoperatively that returned to normal. One patient had transient left lower lip weakness that resolved. Conclusions: This is the first experience with transoral robotic thyroidectomy in the United States. The procedure is feasible and warrants further investigation as it is the only truly scarless approach to the thyroid. No competing financial interests exist. Runtime of video: 7 mins 2 secs