Robotic surgery for the thyroid was developed largely in South Korea and brought to the United States several years ago as a “tool” in thyroid surgery. Its proposed benefits were to be the following:
Absent or less noticeable neck incisions
Improved visualization
Less Surgeon FatigueIncisions are tremendously longer but just not located on the front of the neck
In anaplastic thyroid cancer, it is the wrong surgery! You risk spilling the cancer!
Anaplastic thyroid cancer that is able to undergoe surgery, must also have immediate post surgical chemotherapy and radiation therapy. The radiation treatment field would have to include the entire area of surgery from underneath the arm to the entire neck. This should never be done!
In anaplastic thyroid cancer there is only one chance for surgery and this is the wrong surgery!!
Multiple surgeons are required
The surgeon has no ability to “feel” in the neck. The fingers are the surgeon’s third eye. Subtle changes in feel, hardness or extension of cancer can be totally unappreciated.
It is not minimally invasive by any measure. It is maximally invasive but just at a distance from where the surgery is focusing.
It is a much longer surgical procedure by any measure (the set up of the robot is longer than the average thyroid lobectomy).
It is an inferior surgical approach to manage anaplastic thyroid cancer
Unanticipated findings during surgery may not be able to be adequately addressed robotically.
It may be an acceptable surgical approach for clearly known benign thyroid surgery. Anaplastic thyroid cancer is one of the most aggressive cancers known to mankind!