Dr. William
Armstrong, UC Irvine's director of thyroid and parathyroid
surgery, has trained to learn the intricacies
of using the da Vinci robot for these procedures. The
robotic
thyroidectomy or parathyroidectomy is performed through an axillary (under arm)
incision using the special 3-D endoscope and instruments.
Excellent visualization and dexterity (controlled by the
surgeon) is maintained to perform a safe and
effective robotic thyroidectomy. The robotic thyroidectomy and parathyroidectomy
have many advantages over traditional thyroidectomy or
parathyroidectomy procedures. Robotic thyroid surgery (thyroidectomy) does not mean that there is no human involved with your surgery, but rather the surgeon uses a robotic system to make the surgery safer with less blood loss, and best of all, no scar in the neck.
Prior to robotic thyroidectomy, there were only 2 options for thyroid surgery, traditional thyroidectomy with a 4-6 inch scar in the neck and endoscopic thyroidectomy with a 1-1.5 inch scar in the neck. While endoscopic thyroidectomy was a large leap ahead of traditional thyroidectomy surgery, many patients would like to find an alternative with no scar in the neck.
Robotic-assisted surgery is not new to medicine and has been used in the abdomen and the chest for several years now. Robotic thyroidectomy, though, is quite new and was introduced in the U.S. in the past year.
How Robotic Thyroidectomy Works
In robotic thyroidectomy, the procedure is performed through incisions placed under the two arms. This eliminates the neck scar that many patients desire to avoid.
The procedure (robotic thyroidectomy) is performed with the help of the daVinci Surgical System, which has been used in surgeries for many years. In the surgery, after the under arm incisions are made, tunneling is performed under the skin to reach the neck. The procedure is performed using a high definition 3D camera that can be zoomed in and out. The surgeon sits at a console in the room and controls the specialized robotic instruments (called EndoWrist picture below).
Using the delicate instruments of the robot, the surgeon can remove the diseases areas of the thyroid or parathyroid. The robot is at all times under the control of the surgeon. The robot cannot work independent of the surgeon at all.
Advantages of Robotic
Thyroidectomy
- No neck incision
- 3D magnified view of the structures
- Easier identification of important structures (the nerve that controls your voice)
- Better dexterity using the robotic instruments that can bend more than the human hand
The recovery time for robotic thyroidectomy is generally shorter than open or endoscopic surgery —a patient may spend one day in the hospital following the surgery.
Disadvantage of Robotic
Thyroidectomy
The only disadvantage is that not every
patient is a candidate for robotic
thyroidectomy. Overweight patients with
large glands or tumors and those with
previous surgery, among others cannot have
the surgery performed with the assistance of
a robot.
Best Candidates for Robotic Thyroidectomy?
Many patients qualify for a robotic thyroid surgery procedure. There are many variables that are taken into account when making that decision. Only an experienced surgeon such as Dr. Armstrong can decide which patients are the best candidates for this type of surgery. Other minimally invasive thyroidectomy approaches such as endoscopic thyroidectomy are available for most who do not qualify for the robotic approach.
