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Surgical complications after robotic thyroidectomy for thyroid carcinoma: a single center experience with 3,000 patients

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Abstract

Background

Robotic thyroidectomy (RT), a new gasless, transaxillary approach developed by the Yonsei University group in Seoul, Korea, eliminates the need for a cervical incision. Since RT is technically complex and has a steep learning curve, the surgical complication rate may initially be higher than with conventional surgery. This study evaluated the complication rates of transaxillary RT and assessed ways to prevent surgical complications.

Methods

Between October 2007 and March 2013, 3,000 patients underwent RT for thyroid cancer in the Department of Surgery, Yonsei University College of Medicine at Severance Hospital, Seoul. The medical records of these patients were reviewed retrospectively, and surgical complications were assessed on the basis of clinical findings.

Results

The most common surgical complication was symptomatic hypocalcemia, of which 37.43 % cases were transient and 1.10 % permanent. Other surgical complications included recurrent laryngeal nerve injury (1.23 % transient, 0.27 % permanent), seroma (1.73 %), hematoma (0.37 %), chyle leakage (0.37 %), trachea injury (0.2 %), Horner’s syndrome (0.03 %), carotid artery injury (0.03 %), and brachiocephalic vein injury (0.03 %). The technique-related complications, which were never seen in conventional open thyroidectomy, were axillary skin flap perforation (0.1 %), and traction injury of the arm on the side the lesion was located (0.13 %).

Conclusions

Surgeons who have mastered standardized robotic surgical procedures and who understand potential complications and how to prevent them can perform RT safely.

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Acknowledgments

None

Disclosures

All authors including Drs Ban, Yoo, Kim, Son, Park, Lee, Lee, Kang, Jeong, Nam, Chung, and Park have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, Institute of Endocrine Research, Yonsei University College of Medicine, 50, Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea

    Eun Jeong Ban, Ji Young Yoo, Won Woong Kim, Hae Young Son, Cho Rok Lee, Sang-Wook Kang, Jong Ju Jeong, Kee-Hyun Nam, Woong Youn Chung & Cheong Soo Park

  2. Department of Surgery, Dong-A University College of Medicine, Busan, Korea

    Seulkee Park

  3. Department of Surgery, Catholic University College of Medicine, Seoul, Korea

    So Hee Lee

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  1. Eun Jeong Ban
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Correspondence to Kee-Hyun Nam.

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Ban, E.J., Yoo, J.Y., Kim, W.W. et al. Surgical complications after robotic thyroidectomy for thyroid carcinoma: a single center experience with 3,000 patients. Surg Endosc 28, 2555–2563 (2014). https://doi.org/10.1007/s00464-014-3502-1

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  • DOI: https://doi.org/10.1007/s00464-014-3502-1

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