Surgery for Graves' disease in the era of robotic-assisted surgery: a study of safety and feasibility in the Western population.

PURPOSE

Thyroid surgery for Graves' disease is known to be associated with higher risk of complications. We seek to compare outcomes between robotic-assisted and open cervical approach thyroid surgery in patients with Graves' disease in the Western population.

METHODS

We performed a retrospective cohort study using prospectively collected databases for patients undergoing robotic-assisted or conventional cervical approach thyroid surgery for Graves' disease at two academic medical centers, one in North America (New Orleans, LA) and one in Europe (Paris, France).

RESULTS

A total of 102 patients were included, of which 56 (55%) underwent robotic thyroidectomy and 46 (45%) underwent conventional open cervical thyroidectomy. Mean age was 40.2 ± 13.2 years and 94 (92%) were females. Mean BMI for the sample was 27.7 ± 10.2 kg/m. There was a trend towards larger specimen volume in the robotic-assisted group, 84.9 ± 62.2 cm versus 65.2 ± 40.5 cm (p = 0.07). Mean length of stay for the French patients undergoing robotic-assisted surgery was 3.2 ± 0.5 days. For the American cohort, length of stay was significantly shorter for robotic-assisted thyroidectomy, at 0.8 ± 0.4 days versus 1.0 ± 0.2 days (p = 0.003). Operative time was longer in patients who underwent robotic thyroidectomy (174.4 ± 33.5 min) compared to patients who underwent traditional cervical approach (121.2 ± 41.1 min, p < 0.0001). There was no difference in complication rates for the overall sample of patients undergoing robotic-assisted or open cervical procedures.

CONCLUSION

Robotic thyroid surgery is safe in a select group of patients with Graves' disease in the Western population. Additional studies are warranted to further investigate these findings.