The pros and cons of additional axillary arm for transoral robotic thyroidectomy

• 作者: Bertelli Antonio A.T. Kim Hoon Yub Park Dawon
• 来源期刊: 世界耳鼻咽喉头颈外科杂志（英文）
• 关键词: Transoral thyroidectomy Transoral vestibular approach thyroidectomy Robotic thyroidectomy Robotic surgery Minimally invasive surgery Thyroid surgery Transoral robotic thyroidectomy Transoral endoscopic thyroidectomy vestibular approach
• 年，卷（期）: 2020,（3）
• 所属期刊栏目: Review Article
• 页码范围: 161-164
• 页数: 4页
• 语种: 中文
• DOI: 10.1016/j.wjorl.2020.01.010

摘要

Background::Transoral vestibular approach thyroidectomy using robotic system has advantages with articulating instrumentation. Transoral robotic thyroidectomy (TORT) can be done either using just two robot arms for instruments and an extra one for the endoscopic camera, or using three robot arms for instruments (third arm through axila) and an additional arm for the camera.Pros of additional axillary arm for TORT::The 4th arm through an additional axillary port is mainly responsible for a counter-traction of strap muscles and thyroid tissue. The additional axillary port tract is also an excellent passage for the specimen removal with lower risk of disruption or fragmentation. Ultimately, these merits from the additional axillary arm allows TORT to be performed safely in a wide range of patient groups.Cons of additional axillary arm for TORT::One of the issue with the additional axillary arm in TORT is that it leaves a cutaneous scar. Another issue to consider is the cost. In some places, robotic surgery operation fee varies with the number of arms used during the operation. Retraction of strap muscles through subcutaneous stitches applied after establishing the working space may make up for the lack of counter-traction.Conclusion::TORT can be done safely with or without the transaxillary arm and surgeon may consider pros and cons based on multiple factors.