Innovation in Thyroid Surgery: A Tridimensional Microsurgical Approach with Robotic Visualization System

  • BACKGROUND/PURPOSE: Significant innovations in thyroid surgery, such as microsurgical technique, are well standardized. However, thyroidectomy is still not free from complications related to recurrent laryngeal nerves and parathyroid glands injury. The purpose of this video is to demonstrate the advantages delivering from a tridimensional approach with Robotic Visualization System (RVS) as a support to traditional thyroidectomy. METHODS: We performed total thyroidectomy using microsurgical technique with tridimensional RVS. This system, represented by Digital Hybrid Visualization with integrated 4K camera technology, is incorporated into a sophisticated microscope (Kinevo 900) which is equipped with an anti-vibration optical system and an integrated software for images transfer. RESULTS: The RVS is extremely efficient; allows to approach precisely deep-seated lesions and perform dissection in complex vascular conditions. Moreover, this system offers an opportunity for ocular-free surgery avoiding uncomfortable working positions. Thus, the surgeons can perform a video-assisted thyroidectomy through a high-resolution tridimensional vision. In addition, the OT staff share the same vision and follow the procedure with fidelity. DISCUSSION: Thyroid surgery requires meticulous dissection of laryngeal nerves and parathyroid glands, whose damage may affect the patients life quality. Although we noted an increase in operating time, the advantages of the RVS in reducing the risk of complications are evident and attributable mostly to a better perception of depth and easy recognition of delicate anatomical structures. CONCLUSION: The application of RVS in thyroid surgery requires experience with microsurgical techniques and improves significantly the post-operative outcomes. Furthermore, this innovative technology might be extremely useful in other fields, such as inferior laryngeal nerve reconstruction.

 

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