Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Otolaryngology, Stanford University, Palo Alto, CA, USA.
Oral Oncol. 2019 Aug;95:136-142. doi: 10.1016/j.oraloncology.2019.06.003. Epub 2019 Jun 22.
Transoral robotic thyroidectomy (TORT) is an ideal method for minimally invasive thyroidectomy, as there is less flap dissection during the procedure and no postoperative scars. However, this method also has the limitation of present DaVinci system and some technical problems related to CO gas insufflation that must be resolved. We investigated the feasibility and safety of gasless TORT using the latest version of the DaVinci system (SP).
From October 2018 to January 2019, we performed 10 surgeries of gasless TORT using the DaVinci SP at Yonsei University Hospital.
Nine patients underwent unilateral thyroid lobectomy and one patient received total thyroidectomy. All operations were successfully completed. Nine cases had papillary thyroid carcinoma, and one had benign nodules. The mean surgical time was 177 min, and the mean hospital stay was 6.3 days. There were no reports of transient or permanent vocal cord palsy, recurrence, or mortality during the follow-up period. Temporary hypoesthesia of the chin due to mental nerve injury was observed in 3 of 10 patients, but it recovered spontaneously within 1 months in all cases.
Gasless TORT using the DaVinci SP system is feasible and safe for selected patients and is a potential alternative approach for scarless thyroid surgery.
经口机器人甲状腺切除术（TORT）是微创甲状腺切除术的理想方法，因为在手术过程中皮瓣分离较少，且术后无瘢痕。然而，这种方法也存在现有达芬奇系统的局限性和与 CO2 注气相关的一些技术问题，必须加以解决。我们研究了使用最新版达芬奇系统（SP）进行无气 TORT 的可行性和安全性。
2018 年 10 月至 2019 年 1 月，我们在延世大学医院使用达芬奇 SP 进行了 10 例无气 TORT 手术。
9 例患者行单侧甲状腺叶切除术，1 例患者行甲状腺全切除术。所有手术均顺利完成。9 例为甲状腺乳头状癌，1 例为良性结节。平均手术时间为 177 分钟，平均住院时间为 6.3 天。在随访期间，无暂时性或永久性声带麻痹、复发或死亡报告。10 例患者中有 3 例出现颏神经损伤导致的暂时性颏部感觉减退，但所有患者均在 1 个月内自发恢复。
使用达芬奇 SP 系统进行无气 TORT 对于选定的患者是可行和安全的，是一种无疤痕甲状腺手术的潜在替代方法。
