• TRANSAXILLARY
• THYROID SURGERY
• ROBOT ASSISTED

Background. No studies have compared Robot assisted transaxillary thyroidectomy (RATT) and Minimally Invasive Videoassisted Thyroidectomy (MIVAT) regarding cosmetic outcome and satisfaction

Methods
Patients matching the inclusion criteria (benign nodule less than 6 cm and thyroid volume less than 30 mL) were randomly allotted to undergo MIVAT (group A) or RATT (group B). Cosmetic result, overall satisfaction, operative time and complications were evaluated.
Results
62 patients underwent hemithyroidectomy (30 in group A and 32 in group B). All patients were females except one male in each group. Mean age was 36.9 years (group A) and 33.8 years (group B). Nodule diameter was larger in group B (33.9 mm) than in group A (15.2 mm). Surgical time was comparable: 46.5 minutes in group A and 54.9 minutes in group B. Total time (intubation-extubation) was shorter in group A (71.6 minutes) than in group B (122.6 minutes). Complications were one transient laryngeal nerve injury in both groups and one subcutaneous hematoma in group B. Postoperative stay was longer in group B (1.92 days) than in group A (1.15 days).
On the PASQ questionnaire, “scar appearance” and “satisfaction with appearance” scores resulted better in group A than in group B. In the SF-36 questionnaire, domains of “social activity” and “general health” were better in group B than in group A, while “bodily pain” resulted higher in group B than in group A.
Conclusions
RATT seems not to overcome MIVAT when comparing two groups of patients undergoing thyroidectomy for benign disease, although nodule diameter was significantly larger in the RATT group.