Robot-Assisted Transaxillary Thyroidectomy

Gasless robot-assisted transaxillary thyroidectomy, popularized in South Korea, was introduced in order to satisfy the desire to avoid a neck scar in patients scheduled for thyroidectomy. Although this approach became widely used in Asian countries, its diffusion in Europe and the United States was slower. This relates to anthropometric and cultural differences, as well as to the smaller thyroid glands and nodules being excised in Asian countries as a result of screening programs. Moreover, the elevated costs of the procedure, the need for training and the introduction of novel complications may have initially hindered the uptake of this approach in the Western world. To date, although robot-assisted transaxillary thyroidectomy has shown promising results in feasibility, safety and patient satisfaction, in the Western world it plays only a niche role for treating selected patients with appropriate pathology in high-volume centers. Nevertheless, several interesting studies have reported encouraging results even in the treatment of complex or advanced cases.