Kim Kwangsoon
Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Gland Surg. 2025 Jan 24;14(1):74-81. doi: 10.21037/gs-24-409. Epub 2025 Jan 9.
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.
单孔（SP）经腋窝机器人甲状腺切除术是内分泌外科领域的一项重大创新，提供了一种微创方法，将肿瘤治疗效果与改善美容效果相结合。SP机器人系统的引入使外科医生能够通过单个腋窝切口进行甲状腺切除术和侧颈淋巴结清扫，从而实现颈部无瘢痕且术后发病率降低。本综述探讨了与SP经腋窝机器人甲状腺切除术相关的当前实践和手术技术，强调了SP机器人系统相对于传统多孔和开放手术方法的优势。由于其关节式器械和高清三维可视化，该系统具有更高的精度，能够进行细致的解剖，将喉返神经损伤和低钙血症等并发症的风险降至最低。SP设计简化了手术过程，减少了对周围组织的创伤，从而缩短了恢复时间并提高了患者满意度。SP手术方法的临床结果令人鼓舞，研究表明其肿瘤学安全性与传统方法相当，美容效果更佳。患者满意度特别高，尤其是对于没有可见颈部瘢痕而言。然而，该技术的应用受到其陡峭的学习曲线和SP机器人系统高成本的限制。本综述还强调需要进一步进行长期研究，以全面评估SP机器人系统优势的可持续性，特别是在肿瘤学结果和成本效益方面。讨论了SP经腋窝手术方法成为甲状腺手术标准选择的潜力，以及持续研究和外科医生培训以优化其使用的重要性。总之，SP经腋窝机器人甲状腺切除术为传统方法提供了一个有吸引力的替代方案，有可能显著改善甲状腺手术的患者预后和满意度。
