Benefits of Robotic Thyroidectomy

What is a thyroidectomy?

A thyroidectomy is a removal of part or all of the thyroid gland, which is located at the base of the neck. There are a number of reasons why people might require a partial or total thyroidectomy, including thyroid cancer, overactive thyroid, and enlargement of the thyroid.

Thyroidectomies involve either the removal of one lobe or one half of the thyroid gland (hemithyroidectomy), or the removal of the entire thyroid gland (total thyroidectomy). This depends on the suspected preoperative diagnosis, including the result of the fine needle aspiration biopsy conducted prior to surgery, as well as the intraoperative analysis of the tumor by the pathologist during surgery. (Once the involved half of the thyroid is removed, the tissue is sent immediately for frozen or quick section analysis by a pathologist. At this point, if the nodule is determined–or confirmed–to be malignant, then the other half of the thyroid gland is removed as well.)

For many years, traditional open surgery has been a safe and effective treatment for thyroid removal. Thyroid operations are almost always performed under general anesthesia. The incision is placed in the low anterior neck just above the collar line and will vary in length depending on the size of the nodule (in suspected cancer cases), the shape and size of your neck, and the surgeon’s preferences. In general, thyroidectomy incisions tend to be between 6-10 cm in length.

Surgeons have also utilized endoscopic (minimally invasive) techniques to minimize the size of the incision on the patient’s neck. During endoscopic surgery, the surgeon utilizes a small camera to see what he or she is working on while they perform the surgery with special instruments. There are different approaches available, but most involve an incision in the neck, leaving a 3-4 cm scar even in best cases.

What is a robotic thyroidectomy?
The robotic thyroidectomy is a revolutionary alternative to traditional thyroid surgery. Instead of accessing the thyroid gland at the base of the neck, the robotic thyroidectomy accesses it through an incision under the arm. This is called an axillary approach. That incision is 5-6 cm long, but it’s hidden–unlike the incisions from open or even most endoscopic thyroidectomies. There’s another very small incision–5 mm–in the chest; however, in many cases, the chest incision is not required. Once the incision is made under the arm, the thyroid gland is accessed utilizing the da Vinci®-S Surgical System. By approaching the thyroid through an incision in the axillary fold (under the arm) and using the da Vinci system, we are able to eliminate the neck scar and reduce post-surgical numbness of the anterior neck.

The robotic thyroidectomy is a very precise and specific procedure requiring significant training. Currently, there are only a handful of surgeons in the country trained and qualified to perform them. Jay Roberts, M.D., a board-certified otolaryngologist, or ENT specialist, practicing at Physicians Regional Healthcare System in Naples, Florida is counted among them.

Who can have a robotic thyroidectomy?
Currently, robotic thyroidectomies work best for patients who:

  • Are not overweight
  • Have a smaller thyroid gland (4 cm at the largest)
  • Have smaller nodules (2 cm at the largest)
  • Have nodules on just one side of the thyroid gland