Da Vinci Thyroid Studies Suggest Advantages, Disadvantages Compared to Endoscopic and Open Surgery
By John Otrompke
Korean surgeons have now gained enough experience using the da Vinci surgical robot to perform operations for thyroid cancer that researchers are able to describe preliminary findings comparing robotic to endoscopic to conventional open procedures.
To a significant extent, more lymph nodes are retrieved in robotic thyroidectomies than in conventional endoscopic procedures, research indicates. If compared to open surgery, however, the same number of lymph nodes were retrieved, according to a smaller, preliminary comparative study.
The rate of transient hypocalcemia was significantly greater in robotic surgery than in endoscopic procedures, however, as was the rate of permanent recurrent laryngeal nerve palsy.
Post-operative mean thyroglobulin level, used as a surrogate marker for remaining or recurring cancer, was lower in robotic procedures than in open procedures. Hyperesthesia or paresthesia was also diminished in patients who had robotic procedures in comparison with conventional open thyroidectomy, according to research which has yet to be published.
“There are technically some limitations of robotic surgery compared to conventional open surgery for advanced thyroid surgery, such as trachea resection and reconstruction, as well as mediastinal lymph node dissection,” said Dr. Woong Youn Chung, surgeon at Yonsei University College of Medicine, in Seoul.
“Compared to endoscopic surgery, however, we can applied robot surgery to more advanced thyroid cancer,” said Chung, who has been performing robotic surgeries since October of 2007.
Robotic procedures may also offer the advantage of diminished scarring of the neck, he added.
Chung had performed the robotic surgery in 200 consecutive patients in July 2008, and a paper describing the results, titled “Robot-Assisted Endoscopic Thyroidectomy for Thyroid Malignancies Using a Gasless Transaxillary Approach,” was published in 2009 in the Journal of the American College of Surgeons.
Now, Chung is updating his data and comparing those patients who had robotic thyroidectomies with those who had endoscopic procedures, in a forthcoming article in the Annals of Surgery. Although mean follow-up time is relatively short at 9.5 months, by March of 2011, Chung and colleagues had performed more than 2,000 such cases, and C hung himself had performed about 1,400 of them. As of last year, a total of about 4,100 robotic thyroidectomies had been performed in Korea, Chung added.
In a smaller group of 115 patients, Chung and colleague also have compared robotic thyroidectomy with open thyroidectomy, in research yet to be published.
By John Otrompke
Korean surgeons have now gained enough experience using the da Vinci surgical robot to perform operations for thyroid cancer that researchers are able to describe preliminary findings comparing robotic to endoscopic to conventional open procedures.
To a significant extent, more lymph nodes are retrieved in robotic thyroidectomies than in conventional endoscopic procedures, research indicates. If compared to open surgery, however, the same number of lymph nodes were retrieved, according to a smaller, preliminary comparative study.
The rate of transient hypocalcemia was significantly greater in robotic surgery than in endoscopic procedures, however, as was the rate of permanent recurrent laryngeal nerve palsy.
Post-operative mean thyroglobulin level, used as a surrogate marker for remaining or recurring cancer, was lower in robotic procedures than in open procedures. Hyperesthesia or paresthesia was also diminished in patients who had robotic procedures in comparison with conventional open thyroidectomy, according to research which has yet to be published.
“There are technically some limitations of robotic surgery compared to conventional open surgery for advanced thyroid surgery, such as trachea resection and reconstruction, as well as mediastinal lymph node dissection,” said Dr. Woong Youn Chung, surgeon at Yonsei University College of Medicine, in Seoul.
“Compared to endoscopic surgery, however, we can applied robot surgery to more advanced thyroid cancer,” said Chung, who has been performing robotic surgeries since October of 2007.
Robotic procedures may also offer the advantage of diminished scarring of the neck, he added.
Chung had performed the robotic surgery in 200 consecutive patients in July 2008, and a paper describing the results, titled “Robot-Assisted Endoscopic Thyroidectomy for Thyroid Malignancies Using a Gasless Transaxillary Approach,” was published in 2009 in the Journal of the American College of Surgeons.
Now, Chung is updating his data and comparing those patients who had robotic thyroidectomies with those who had endoscopic procedures, in a forthcoming article in the Annals of Surgery. Although mean follow-up time is relatively short at 9.5 months, by March of 2011, Chung and colleagues had performed more than 2,000 such cases, and C hung himself had performed about 1,400 of them. As of last year, a total of about 4,100 robotic thyroidectomies had been performed in Korea, Chung added.
In a smaller group of 115 patients, Chung and colleague also have compared robotic thyroidectomy with open thyroidectomy, in research yet to be published.
posted by John J. Otrompke | 1:07 PM
<< Home