Bu Ali, Daniah1, Aidan, Patrick2, Murad, Fadi1, Kang, Sang-Wook1; Kandil, Emad1
1 Department of surgery, Tulane University School of Medicine, New Orleans, LA, USA
2 American Hospital in Paris, Paris, France
Background: The robot-assisted approach for thyroid and parathyroid surgery has been of increased interest recently in Asia, United Stated and Europe. However, only few studies with small sample size reported the safety of this approach in parathyroid surgery. The aim of this study is to assess the safety and feasibility of robot-assisted parathyroid surgery in patients with primary hyperparathyroidism (PHPT).
Methods: Retrospective review of all patients with PHPT who underwent robot-assisted parathyroidectomy, in two centers over five years. We assessed demographic data and operative outcome measures including; operative time, estimated blood loss and associated complications.
Results: A total of thirty-seven procedures were performed, with preoperatively localized adenomas. The mean age was 55.1±10 and BMI was 25.98±5.89 with a female to male ratio of 4.3:1. Transaxillary approach was used in 91.9% and the remaining patients underwent retroauricular approach, with no reported cases of conversion to open. The mean operative time was 132± 32.5 min. All patients had curative surgery, proven by drop of intraoperative parathyroid hormone level to normal range; which was maintained on follow up visits. Only two minor complications were reported; one patient developed seroma and one had superficial wound infection.
Conclusions: To our knowledge, this is the largest reported series on robot-assisted parathyroid surgery. This technique using either the transaxillary or retroauricular approaches is safe and feasible in selected patients with localized preoperative scans. It can be considered as an alternative for conventional open approach, especially in patients with concerns of a visible neck scar.