Robots Can Remove Thyroid Without Neck Incision

Robots can be employed to remove a diseased thyroid, or at least a portion of it, without the hallmark neck incision, researchers said. The thyroid, which sits just under the Adam’s apple and controls the body’s metabolic rate, is about the size of a kiwi. Benign and cancerous disease can more than double its size. Dr. David Terris, Porubsky professor and chairman of the Medical College of Georgia Department of Otolaryngology-Head and Neck Surgery, has helped shepherd in minimally-invasive approaches that reduced neck incisions from several inches to less than an inch within the last few years. The daVinci Surgical System, in which surgeons sitting at a console maneuver through tight spaces and around corners, enables access to the thyroid through the armpit, Terris said. “In my opinion, if you are committed to not having a neck scar, this is the best way to do it,” Terris said of patients who are trim, have benign disease and need only half of their two-lobed thyroid gland removed. He and his colleagues — Dr. F. Christopher Holsinger, associate professor at the University of Texas MD Anderson Cancer Center, and Dr. Ronald B. Kuppersmith, clinical faculty member at Texas A & M Health Science Center — provide an overview of the robotic technique they are helping develop in the United States in the current print edition of Otolaryngologic Clinics of North America. Although the armpit is farther from the gland than the neck is, simply raising the patient’s arm during surgery shortens the path, leaving a fairly straightforward approach made navigable by the three- dimensional visualization and wrist-like maneuverability of the robot.