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Robotic endocrine surgery: technical details and review of the literature

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Abstract

Over the last decade, robotic technology has been used in multiple general surgical procedures. Endocrine surgeons have embraced this technology and subsequently transformed neck operations into more cosmetically acceptable procedures and improved ergonomics. Technical details of various robotic endocrine surgical procedures have recently been described. The aim of this review is to illustrate these technical details and analyze the current data to propose an evidence-based approach to robotic endocrine surgery.

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References

  1. Geis WP, Kim HC, Brennan EJ Jr, McAfee PC, Wang Y (1996) Robotic arm enhancement to accommodate improved efficiency and decreased resource utilization in complex minimally invasive surgical procedures. Stud Health Technol Inform 29:471–481

    PubMed  CAS  Google Scholar 

  2. Hazey JW, Melvin WS (2004) Robot-assisted general surgery. Semin Laparosc Surg 11(2):107–112

    PubMed  Google Scholar 

  3. Satava RM (2002) Surgical robotics: the early chronicles: a personal historical perspective. Surg Laparosc Endosc Percutan Tech 12(1):6–16

    Article  PubMed  Google Scholar 

  4. Cadiere GB, Himpens J, Germay O, Izizaw R, Degueldre M, Vandromme J, Capelluto E, Bruyns J (2001) Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg 25(11):1467–1477

    PubMed  CAS  Google Scholar 

  5. Horgan S, Vanuno D (2001) Robots in laparoscopic surgery. J Laparoendosc Adv Surg Tech A 11(6):415–419

    Article  PubMed  CAS  Google Scholar 

  6. Lobe TE, Wright SK, Irish MS (2005) Novel uses of surgical robotics in head and neck surgery. J Laparoendosc Adv Surg Tech A 15(6):647–652

    Article  PubMed  Google Scholar 

  7. Gagner M (1996) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 83(6):875

    Article  PubMed  CAS  Google Scholar 

  8. Hüscher CS, Chiodini S, Napolitano C, Recher A (1997) Endoscopic right thyroid lobectomy. Surg Endosc 11(8):877

    Article  PubMed  Google Scholar 

  9. Ikeda Y, Takami H, Niimi M, Kan S, Sasaki Y, Takayama J (2001) Endoscopic thyroidectomy by the axillary approach. Surg Endosc 15(11):1362–1364

    Article  PubMed  CAS  Google Scholar 

  10. Ohgami M, Ishii S, Arisawa Y, Ohmori T, Noga K, Furukawa T, Kitajima M (2000) Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech 10(1):1–4

    PubMed  CAS  Google Scholar 

  11. Shimazu K, Shiba E, Tamaki Y, Takiguchi S, Taniguchi E, Ohashi S, Noguchi S (2003) Endoscopic thyroid surgery through the axillo-bilateral-breast approach. Surg Laparosc Endosc Percutan Tech 13(3):196–201

    Article  PubMed  Google Scholar 

  12. Shimizu K, Akira S, Jasmi AY, Kitamura Y, Kitagawa W, Akasu H, Tanaka S (1999) Video-assisted neck surgery: endoscopic resection of thyroid tumors with a very minimal neck wound. J Am Coll Surg 188(6):697–703

    Article  PubMed  CAS  Google Scholar 

  13. Lee J, Lee JH, Nah KY, Soh EY, Chung WY (2011) Comparison of endoscopic and robotic thyroidectomy. Ann Surg Oncol 18(5):1439–1446

    Google Scholar 

  14. Yoon JH, Park CH, Chung WY (2006) Gasless endoscopic thyroidectomy via an axillary approach: experience of 30 cases. Surg Laparosc Endosc Percutan Tech 16(4):226–231

    Article  PubMed  Google Scholar 

  15. Kang SW, Lee SC, Lee SH, Lee KY, Jeong JJ, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: the operative outcomes of 338 consecutive patients. Surgery 146(6):1048–1055

    Article  PubMed  Google Scholar 

  16. Kang SW, Jeong JJ, Yun JS, Sung TY, Lee SC, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Robot-assisted endoscopic surgery for thyroid cancer: experience with the first 100 patients. Surg Endosc 23(11):2399–2406

    Article  PubMed  Google Scholar 

  17. Lee KE, Koo DH, Kim SJ, Lee J, Park KS, Oh SK, Youn YK (2010) Outcomes of 109 patients with papillary thyroid carcinoma who underwent robotic total thyroidectomy with central node dissection via the bilateral axillo-breast approach. Surgery 148(6):1207–1213

    Article  PubMed  Google Scholar 

  18. Lewis CM, Chung WY, Holsinger FC (2010) Feasibility and surgical approach of transaxillary robotic thyroidectomy without CO(2) insufflation. Head Neck 32(1):121–126

    PubMed  Google Scholar 

  19. Landry CS, Grubbs EG, Perrier ND (2010) Bilateral robotic-assisted transaxillary surgery. Arch Surg 145(8):717–720

    Article  PubMed  Google Scholar 

  20. Ryu HR, Kang SW, Lee SH, Rhee KY, Jeong JJ, Nam KH, Chung WY, Park CS (2010) Feasibility and safety of a new robotic thyroidectomy through a gasless, transaxillary single-incision approach. J Am Coll Surg 211(3):e13–e19

    Article  PubMed  Google Scholar 

  21. Lee J, Kang SW, Jung JJ, Choi UJ, Yun JH, Nam KH, Soh EY, Chung WY (2011) Multicenter study of robotic thyroidectomy: short-term postoperative outcomes and surgeon ergonomic considerations. Ann Surg Oncol. doi:10.1245/s10434-011-1628-0

  22. Seybt M, Kuppersmith RB, Holsinger FC, Terris DJ (2010) Robotic axillary thyroidectomy: multi-institutional clinical experience with the daVinci. Laryngoscope 120[Suppl 4]:S182

  23. Kang SW, Lee SH, Ryu HR, Lee KY, Jeong JJ, Nam KH, Chung WY, Park CS (2010) Initial experience with robot-assisted modified radical neck dissection for the management of thyroid carcinoma with lateral neck node metastasis. Surgery 148(6):1214–1221

    Article  PubMed  Google Scholar 

  24. Lang BH, Chow MP (2011) A comparison of surgical outcomes between endoscopic and robotically assisted thyroidectomy: the authors’ initial experience. Surg Endosc 25(5):1617–1623

    Google Scholar 

  25. Lee J, Yun JH, Nam KH, Choi UJ, Chung WY, Soh EY (2011) Perioperative clinical outcomes after robotic thyroidectomy for thyroid carcinoma: a multicenter study. Surg Endosc 25(3):906–912

    Article  PubMed  Google Scholar 

  26. Lee J, Yun JH, Nam KH, Soh EY, Chung WY (2011) The learning curve for robotic thyroidectomy: a multicenter study. Ann Surg Oncol 18(1):226–232

    Article  PubMed  Google Scholar 

  27. Tae K, Ji YB, Jeong JH, Lee SH, Jeong MA, Park CW (2011) Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach: our early experiences. Surg Endosc 25(1):221–228

    Article  PubMed  Google Scholar 

  28. Lee J, Nah KY, Kim RM, Ahn YH, Soh EY, Chung WY (2010) Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy. Surg Endosc 24(12):3186–3194

    Article  PubMed  Google Scholar 

  29. Berber E, Heiden K, Akyildiz H, Milas M, Mitchell J, Siperstein A (2010) Robotic transaxillary thyroidectomy: report of 2 cases and description of the technique. Surg Laparosc Endosc Percutan Tech 20(2):e60–e63

    Article  PubMed  Google Scholar 

  30. Lee KE, Rao J, Youn YK (2009) Endoscopic thyroidectomy with the da Vinci robot system using the bilateral axillary breast approach (BABA) technique: our initial experience. Surg Laparosc Endosc Percutan Tech 19(3):e71–e75

    Article  PubMed  Google Scholar 

  31. Kang SW, Jeong JJ, Nam KH, Chang HS, Chung WY, Park CS (2009) Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach. J Am Coll Surg 209(2):e1–e7

    Article  PubMed  Google Scholar 

  32. Miyano G, Lobe TE, Wright SK (2008) Bilateral transaxillary endoscopic total thyroidectomy. J Pediatr Surg 43(2):299–303

    Article  PubMed  Google Scholar 

  33. Landry CS, Grubbs EG, Stephen Morris G, Turner NS, Christopher Holsinger F, Lee JE, Perrier ND (2011) Robot assisted transaxillary surgery (RATS) for the removal of thyroid and parathyroid glands. Surgery 149(4):549–555

    Article  PubMed  Google Scholar 

  34. Kandil E, Abdel Khalek M, Thomas M, Bellows CF (2011) Are bilateral axillary incisions needed or is just a single unilateral incision sufficient for robotic-assisted total thyroidectomy? Arch Surg 146(2):240–241

    Article  PubMed  Google Scholar 

  35. Arora A, Cunningham A, Chawdhary G, Vicini C, Weinstein GS, Darzi A, Tolley N (2011) Clinical applications of telerobotic ENT-head and neck surgery. Int J Surg 9(4):277–284

    Google Scholar 

  36. Gottlieb A, Sprung J, Zheng XM, Gagner M (1997) Massive subcutaneous emphysema and severe hypercarbia in a patient during endoscopic transcervical parathyroidectomy using carbon dioxide insufflation. Anesth Analg 84(5):1154–1156

    PubMed  CAS  Google Scholar 

  37. Miccoli P, Bendinelli C, Conte M, Pinchera A, Marcocci C (1998) Endoscopic parathyroidectomy by a gasless approach. J Laparoendosc Adv Surg Tech A 8(4):189–194

    Article  PubMed  CAS  Google Scholar 

  38. Miccoli P, Bendinelli C, Berti P, Vignali E, Pinchera A, Marcocci C (1999) Video-assisted versus conventional parathyroidectomy in primary hyperparathyroidism: a prospective randomized study. Surgery 126(6):1117–1121

    Article  PubMed  CAS  Google Scholar 

  39. Profanter C, Schmid T, Prommegger R, Bale R, Sauper T, Bodner J (2004) Robot-assisted mediastinal parathyroidectomy. Surg Endosc 18(5):868–870

    Article  PubMed  CAS  Google Scholar 

  40. Bodner J, Wykypiel H, Greiner A, Kirchmayr W, Freund MC, Margreiter R, Schmid T (2004) Early experience with robot-assisted surgery for mediastinal masses. Ann Thorac Surg 78(1):259–265

    Article  PubMed  Google Scholar 

  41. Harvey A, Bohacek L, Neumann D, Mihaljevic T, Berber E (2011) Robotic thoracoscopic mediastinal parathyroidectomy for persistent hyperparathyroidism: case report and review of the literature. Surg Laparosc Endosc Percutan Tech 21(1):e24–e27

    Article  PubMed  Google Scholar 

  42. Chan AP, Wan IY, Wong RH, Hsin MK, Underwood MJ (2010) Robot-assisted excision of ectopic mediastinal parathyroid adenoma. Asian Cardiovasc Thorac Ann 18(1):65–67

    PubMed  Google Scholar 

  43. Ismail M, Maza S, Swierzy M, Tsilimparis N, Rogalla P, Sandrock D, Rückert RI, Müller JM, Rückert JC (2010) Resection of ectopic mediastinal parathyroid glands with the da Vinci robotic system. Br J Surg 97(3):337–343

    Article  PubMed  CAS  Google Scholar 

  44. Braumann C, Jacobi CA, Menenakos C, Ismail M, Rueckert JC, Mueller JM (2008) Robotic-assisted laparoscopic and thoracoscopic surgery with the da Vinci system: a 4-year experience in a single institution. Surg Laparosc Endosc Percutan Tech 18(3):260–266

    Article  PubMed  Google Scholar 

  45. Timmerman GL, Allard B, Lovrien F, Hickey D (2008) Hyperparathyroidism: robotic-assisted thoracoscopic resection of a supernumary anterior mediastinal parathyroid tumor. J Laparoendosc Adv Surg Tech A 18(1):76–79

    Article  PubMed  Google Scholar 

  46. Augustin F, Schmid T, Bodner J (2006) The robotic approach for mediastinal lesions. Int J Med Robot 2(3):262–270

    Article  PubMed  Google Scholar 

  47. Tanna N, Joshi AS, Glade RS, Zalkind D, Sadeghi N (2006) Da Vinci robot-assisted endocrine surgery: novel applications in otolaryngology. Otolaryngol Head Neck Surg 135(4):633–635

    Article  PubMed  Google Scholar 

  48. Piazza L, Caragliano P, Scardilli M, Sgroi AV, Marino G, Giannone G (1999) Laparoscopic robot-assisted right adrenalectomy and left ovariectomy (case reports). Chir Ital 51(6):465–466

    PubMed  CAS  Google Scholar 

  49. Hubens G, Ysebaert D, Vaneerdeweg W, Chapelle T, Eyskens E (1999) Laparoscopic adrenalectomy with the aid of the AESOP 2000 robot. Acta Chir Belg 99(3):125–127

    PubMed  CAS  Google Scholar 

  50. Gill IS, Sung GT, Hsu TH, Meraney AM (2000) Robotic remote laparoscopic nephrectomy and adrenalectomy: the initial experience. J Urol 164(6):2082–2085

    Article  PubMed  CAS  Google Scholar 

  51. Choi KH, Ham WS, Rha KH, Lee JW, Jeon HG, Arkoncel FR, Yang SC, Han WK (2011) Laparoendoscopic single-site surgeries: a single-center experience of 171 consecutive cases. Korean J Urol 52(1):31–38

    Article  PubMed  Google Scholar 

  52. Giulianotti PC, Buchs NC, Addeo P, Bianco FM, Ayloo SM, Caravaglios G, Coratti A (2011) Robot-assisted adrenalectomy: a technical option for the surgeon? Int J Med Robot 7(1):27–32

    Article  PubMed  CAS  Google Scholar 

  53. Berber E, Mitchell J, Milas M, Siperstein A (2010) Robotic posterior retroperitoneal adrenalectomy: operative technique. Arch Surg 145(8):781–784

    Article  PubMed  Google Scholar 

  54. Boris RS, Gupta G, Linehan WM, Pinto PA, Bratslavsky G (2011) Robot-assisted laparoscopic partial adrenalectomy: initial experience. Urology 77(4):775–780

    Google Scholar 

  55. Brunaud L, Ayav A, Zarnegar R, Rouers A, Klein M, Boissel P, Bresler L (2008) Prospective evaluation of 100 robotic-assisted unilateral adrenalectomies. Surgery 144(6):995–1001

    Article  PubMed  Google Scholar 

  56. Wu JC, Wu HS, Lin MS, Chou DA, Huang MH (2008) Comparison of robot-assisted laparoscopic adrenalectomy with traditional laparoscopic adrenalectomy—1 year follow-up. Surg Endosc 22(2):463–466

    Article  PubMed  Google Scholar 

  57. Krane LS, Shrivastava A, Eun D, Narra V, Bhandari M, Menon M (2008) A four-step technique of robotic right adrenalectomy: initial experience. BJU Int 101(10):1289–1292

    Article  PubMed  Google Scholar 

  58. Winter JM, Talamini MA, Stanfield CL, Chang DC, Hundt JD, Dackiw AP, Campbell KA, Schulick RD (2006) Thirty robotic adrenalectomies: a single institution’s experience. Surg Endosc 20(1):119–124

    Article  PubMed  CAS  Google Scholar 

  59. Miyake O, Kiuchi H, Yoshimura K, Okuyama A (2005) Urological robotic surgery: preliminary experience with the ZEUS system. Int J Urol 12(10):928–932

    Article  PubMed  Google Scholar 

  60. Corcione F, Esposito C, Cuccurullo D, Settembre A, Miranda N, Amato F, Pirozzi F, Caiazzo P (2005) Advantages and limits of robot-assisted laparoscopic surgery: preliminary experience. Surg Endosc 19(1):117–119

    Article  PubMed  CAS  Google Scholar 

  61. Morino M, Benincà G, Giraudo G, Del Genio GM, Rebecchi F, Garrone C (2004) Robot-assisted vs laparoscopic adrenalectomy: a prospective randomized controlled trial. Surg Endosc 18(12):1742–1746

    Article  PubMed  CAS  Google Scholar 

  62. Hanly EJ, Talamini MA (2004) Robotic abdominal surgery. Am J Surg 188[4A Suppl]:19S–26S

    Article  PubMed  Google Scholar 

  63. Undre S, Moorthy K, Munz Y, Aggarwal R, Hance J, Rockall T, Darzi A (2004) Robot-assisted laparoscopic Heller cardiomyotomy: preliminary UK results. Dig Surg 21(5–6):396–400

    Article  PubMed  CAS  Google Scholar 

  64. Talamini MA, Chapman S, Horgan S, Melvin WS, Academic Robotics Group (2003) A prospective analysis of 211 robotic-assisted surgical procedures. Surg Endosc 17(10):1521–1524

    Article  PubMed  CAS  Google Scholar 

  65. Desai MM, Gill IS, Kaouk JH, Matin SF, Sung GT, Bravo EL (2002) Robotic-assisted laparoscopic adrenalectomy. Urology 60(6):1104–1107

    Article  PubMed  Google Scholar 

  66. Bentas W, Wolfram M, Bräutigam R, Binder J (2002) Laparoscopic transperitoneal adrenalectomy using a remote-controlled robotic surgical system. J Endourol 16(6):373–376

    Article  PubMed  Google Scholar 

  67. Zafar SS, Abaza R (2008) Robot-assisted laparoscopic adrenalectomy for adrenocortical carcinoma: initial report and review of the literature. J Endourol 22(5):985–989

    Article  PubMed  Google Scholar 

  68. Podolsky ER, Feo L, Brooks AD, Castellanos A (2010) Robotic resection of pheochromocytoma in the second trimester of pregnancy. J Soc Laparoendosc Surg 14(2):303–308

    Google Scholar 

  69. Rogers CG, Blatt AM, Miles GE, Linehan WM, Pinto PA (2008) Concurrent robotic partial adrenalectomy and extra-adrenal pheochromocytoma resection in a pediatric patient with von Hippel-Lindau disease. J Endourol 22(7):1501–1503

    Article  PubMed  Google Scholar 

  70. Alqahtani A, Albassam A, Zamakhshary M, Shoukri M, Altokhais T, Aljazairi A, Alzahim A, Mallik M, Alshehri A (2010) Robot-assisted pediatric surgery: how far can we go? World J Surg 34(5):975–978

    Article  PubMed  Google Scholar 

  71. Fechner AJ, Alvarez M, Smith DH, Al-Khan A (2009) Robotic-assisted laparoscopic cerclage in a pregnant patient. Am J Obstet Gynecol 200(2):e10–e11

    Article  PubMed  Google Scholar 

  72. Walz MK, Peitgen K, Diesing D, Petersenn S, Janssen OE, Philipp T, Metz KA, Mann K, Schmid KW, Neumann HP (2004) Partial versus total adrenalectomy by the posterior retroperitoneoscopic approach: early and long-term results of 325 consecutive procedures in primary adrenal neoplasias. World J Surg 28(12):1323–1329

    Article  PubMed  Google Scholar 

  73. Ishidoya S, Ito A, Sakai K, Satoh M, Chiba Y, Sato F, Arai Y (2005) Laparoscopic partial versus total adrenalectomy for aldosterone producing adenoma. J Urol 174(1):40–43

    Article  PubMed  Google Scholar 

  74. Alesina PF, Hommeltenberg S, Meier B, Petersenn S, Lahner H, Schmid KW, Mann K, Walz MK (2010) Posterior retroperitoneoscopic adrenalectomy for clinical and subclinical Cushing’s syndrome. World J Surg 34(6):1391–1397

    Article  PubMed  Google Scholar 

  75. Wang XJ, Shen ZJ, Zhu Y, Zhang RM, Shun FK, Shao Y, Rui WB, He W (2010) Retroperitoneoscopic partial adrenalectomy for small adrenal tumours (<or= 1 cm): the Ruijin clinical experience in 88 patients. BJU Int 105(6):849–853

    Article  PubMed  Google Scholar 

  76. Diner EK, Franks ME, Behari A, Linehan WM, Walther MM (2005) Partial adrenalectomy: the National Cancer Institute experience. Urology 66(1):19–23

    Article  PubMed  Google Scholar 

  77. Sasagawa I, Suzuki Y, Itoh K, Izumi T, Miura M, Suzuki H, Tomita Y (2003) Posterior retroperitoneoscopic partial adrenalectomy: clinical experience in 47 procedures. Eur Urol 43(4):381–385

    Article  PubMed  Google Scholar 

  78. Kumar A, Hyams ES, Stifelman MD (2009) Robot-assisted partial adrenalectomy for isolated adrenal metastasis. J Endourol 23(4):651–654

    Article  PubMed  Google Scholar 

  79. St Julien J, Ball D, Schulick R (2006) Robot-assisted cortical-sparing adrenalectomy in a patient with Von Hippel-Lindau disease and bilateral pheochromocytomas separated by 9 years. J Laparoendosc Adv Surg Tech A 16(5):473–477

    Article  PubMed  Google Scholar 

  80. Brunaud L, Bresler L, Ayav A, Tretou S, Cormier L, Klein M, Boissel P (2003) Advantages of using robotic Da Vinci system for unilateral adrenalectomy: early results. Ann Chir 128(8):530–535

    Article  PubMed  CAS  Google Scholar 

  81. Brunaud L, Bresler L, Zarnegar R, Ayav A, Cormier L, Tretou S, Boissel P (2004) Does robotic adrenalectomy improve patient quality of life when compared to laparoscopic adrenalectomy? World J Surg 28(11):1180–1185

    Article  PubMed  Google Scholar 

  82. Brunaud L, Bresler L, Ayav A, Zarnegar R, Raphoz AL, Levan T, Weryha G, Boissel P (2008) Robotic-assisted adrenalectomy: what advantages compared to lateral transperitoneal laparoscopic adrenalectomy? Am J Surg 195(4):433–438

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Ankara University School of Medicine, Ankara, Turkey

    Volkan Genc

  2. Division of Endocrine Surgery, Endocrinology and Metabolism Institute, Cleveland Clinic, 9500 Euclid Avenue/F20, Cleveland, OH, 44195, USA

    Orhan Agcaoglu & Eren Berber

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  1. Volkan Genc
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  2. Orhan Agcaoglu
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Correspondence to Eren Berber.

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Genc, V., Agcaoglu, O. & Berber, E. Robotic endocrine surgery: technical details and review of the literature. J Robotic Surg 6, 85–97 (2012). https://doi.org/10.1007/s11701-011-0298-z

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