Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea.
Auris Nasus Larynx. 2021 Jun;48(3):331-338. doi: 10.1016/j.anl.2020.06.007. Epub 2020 Jul 4.
Various remote access robotic thyroidectomy techniques have been developed using the da Vinci® surgical system (Intuitive Surgical Inc., Sunnyvale, CA) to hide or avoid neck scarring and overcome the limitations of endoscopic thyroidectomy. Among those used today are the gasless transaxillary approach, the bilateral axillo-breast approach (BABA), the gasless postauricular facelift approach, and the transoral approach. Especially, the recently introduced transoral approach (including robotic and endoscopic procedures) is prominent and now popular worldwide. The most significant advantages of remote access robotic thyroidectomy are excellent postoperative cosmesis and voice outcomes. The important limitations to the adoption of robotic thyroidectomy are the difficult technique, high complication rate during the learning curve, and high cost. In addition, cultural differences, longer operative times, and medicolegal issues are a barrier to the diffusion of robotic thyroidectomy. However, remote access robotic thyroidectomy is feasible, and the outcomes are comparable to those of conventional transcervical thyroidectomy if performed by experienced surgeons in highly selected patients. This article reviews the evolution and recent advances in robotic thyroid surgery.
各种远程访问机器人甲状腺切除术技术已经使用达芬奇®手术系统（Intuitive Surgical Inc.，加利福尼亚州森尼韦尔）发展起来，以隐藏或避免颈部疤痕，并克服内窥镜甲状腺切除术的限制。今天使用的技术包括无气经腋窝入路、双侧腋窝-乳房入路（BABA）、无气耳后除皱入路和经口入路。特别是，最近引入的经口入路（包括机器人和内窥镜手术）引人注目，现在在全球范围内很流行。远程访问机器人甲状腺切除术的最大优势是术后美容效果和嗓音效果良好。采用机器人甲状腺切除术的重要限制是技术难度大、学习曲线期间并发症发生率高以及成本高。此外，文化差异、手术时间较长和医疗法律问题也是机器人甲状腺切除术推广的障碍。然而，如果由经验丰富的外科医生在高度选择的患者中进行操作，远程访问机器人甲状腺切除术是可行的，并且结果与传统经颈甲状腺切除术相当。本文综述了机器人甲状腺手术的发展和最新进展。
