Application of da Vinci robotics in thyroid surgery: a summary of clinical experience of 304 cases in a single center
10.3760/cma.j.cn.115807-20211227-00399
- VernacularTitle:达芬奇机器人技术在甲状腺手术中的应用：单中心304例临床经验总结
- Author:
Cheng WANG
1
;
Chengqiu SUI
;
Han ZHANG
;
Kunlin LI
;
Mingyu YANG
;
Gaofeng XUE
;
Daqi ZHANG
;
Hui SUN
Author Information
1. 吉林大学中日联谊医院甲状腺外科，吉林省外科转化医学重点实验室，吉林省甲状腺疾病防治工程实验室，长春 130033
- Keywords:
Da Vinci robotic system;
Thyroid surgery;
Thyroid carcinoma;
Learning curve;
Recurrent laryngeal nerve;
Hypoparathyroidism
- From:
Chinese Journal of Endocrine Surgery
2022;16(4):396-400
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effectiveness of da Vinci robotics in thyroid surgery.Methods:304 cases of robotic thyroid surgery performed by the same experienced surgeon at the Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University during the period from Apr. 3, 2020 to Nov. 5, 2021 were prospectively included, and the operation time, operation type, postoperative drainage, postoperative hospital stay, total number of lymph node dissection and number of positive lymph nodes, operation complications, and postoperative pain level of all patients were counted. The learning curve was plotted by applying the moving average method, divided into the initial stage and the mature stage, and the differences in surgical outcomes and surgical complications between the two stages were compared. SPSS 23.0 was applied for statistical analysis, and t-test and Mann-Whitney U test were used for comparison of measurement data, and χ2 test was used for comparison of count data. Result:All surgeries were completed successfully without conversion to open cases, including 29 males and 275 females, with a mean age of (33.8±8.9) years and a range of 27-41 years. The mean body mass index (BMI) was (22.9±3.6) kg/m 2 and a range of 20.5-25.4 kg/m 2. The median operative time was 140 min, the median postoperative drainage was 52.5 ml, and the median postoperative hospital stay was 3 days. The mean number of lymph nodes cleared was 4.4±3.5, and the mean number of positive lymph nodes was 0.9±1.7. The incidence of postoperative transient laryngeal nerve (RLN) injury was 3.3%, and the incidence of transient hypoparathyroidism was 0.7%. A significant decrease in operative time occurred after the 26th case and subsequently stabilized. Compared with the initial stage of the learning curve, the mature stage had a shorter operative time (146.0±36.5 vs 198.7±56.7 min, P<0.001) , a lower incidence of temporary RLN injury (2.5% vs 11.5%, P<0.05) , and a lower percentage of benign tumor surgery (12.2% vs 26.9%, P<0.05) . Conclusion:The application of robotic technology in thyroid surgery is safe and reliable, and its successful implementation should follow a corresponding learning curve, from easy to difficult, with different surgical approaches selected according to the patient’s condition, wishes, and the operator’s technical level.
