David J. Terris and Michael C. Singer (eds.)Minimally Invasive and Robotic Thyroid and Parathyroid Surgery201410.1007/978-1-4614-9011-1_21
© Springer Science+Business Media New York 2014
21. The Future of Robotic Thyroid Surgery and Neck Dissection
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Division of Head and Neck Surgery, Stanford University Medical Center, Stanford, CA, USA
Abstract
The present generation of robotic technology has ushered in a revolution in surgical technique for selected patients undergoing thyroidectomy, beginning with Chung’s axillary and culminating with Terris’ facelift approach. Using these complementary approaches, Koh and colleagues have demonstrated the feasibility and reproducibility of robotic neck dissection, with outcomes in early studies comparable to open technique. As new robotic systems come to market and as the current platform is further refined, surgeons can expect smaller systems, with flexible arms, stereo-endoscopes, and new instrumentation to allow greater innovation and refinement of surgical technique in thyroidectomy, parathyroid surgery, and neck dissection.
As the preceding chapters attest, surgical robotics has moved from the realm of fantasy and science fiction to routine clinical practice. At present, the da Vinci Surgical System (Intuitive Surgical Inc., Sunnyvale, CA) is the only commercially available surgical robot. While this system is used extensively to facilitate laparoscopic minimally invasive surgery in the chest, abdomen, and pelvis, its use for surgery of the thyroid, parathyroid, and neck remains investigational. While the currently available 5- and 8-mm instruments have been appropriate for the first generation of robotic neck procedures, as technology improves, robotic systems and instruments will likely be developed whose scale and capabilities are better suited to the delicate, complex anatomy of the thyroid bed and neck.
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