Robotic total parathyroidectomy by the axillo-bilateral-breast approach for secondary hyperparathyroidism: a feasibility study.

Abstract

BACKGROUND:

The aim of this study was to evaluate the clinical application and superiority of the da Vinci(®) Si Surgical System (Intuitive Surgical Inc., Sunnyvale, CA) in total parathyroidectomy for secondary hyperparathyroidism.

MATERIALS AND METHODS:

Total parathyroidectomy was performed with the da Vinci Si Surgical System by the four-trocar axillo-bilateral-breast approach. The patients were placed in the supine position, and the operation procedure included creating the workspace, docking, and consoling stages. The camera arm is centered in the working space. Three working arms are then placed adjacent to the camera. The Harmonic(®) scalpel (Ethicon Endo-surgery, Inc., Cincinnati, OH) was used for hemostasis and gland resection, and dissected parathyroid was taken out by a specimen pouch.

RESULTS:

Total parathyroidectomy with trace amounts of parathyroid tissue autotransplantation in 6 patients was successfully performed with the da Vinci Si Surgical System. There were no operation-related complications and no conversions to open or endoscopic surgery. Mean operation time was 156 minutes. Patients were discharged from the hospital 6 days after surgery. The postoperative cosmetic result was satisfactory, with minimal numbness and tingling on the anterior chest.

CONCLUSIONS:

This initial study shows that robotic total parathyroidectomy via the axillo-bilateral-breast approach is a safe and feasible alternative to selected patients, especially those with esthetic concerns.

• Authors: Qingqing He, Jian Zhu, Dayong Zhuang, Ziyi Fan
• Journal: Journal of laparoendoscopic & advanced surgical techniques. Part A (J Laparoendosc Adv Surg Tech A) Vol. 25 Issue 4 Pg. 311-3 (Apr 2015) ISSN: 1557-9034 [Electronic] United States
• PMID: 25760735 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Axilla
• Breast
• Feasibility Studies
• Female
• Follow-Up Studies
• Humans
• Hyperparathyroidism, Secondary (surgery)
• Length of Stay
• Male
• Middle Aged
• Operative Time
• Parathyroidectomy (methods)
• Robotic Surgical Procedures (methods)
• Treatment Outcome