The future of thyroid surgery

24 year old Priya, a nursing staff by profession first noticed a swelling in her neck about 4 years back. The swelling, initially small in size, started increasing gradually and alarmed she met a doct

By: Dr Umanath Nayak | | Updated: March 23, 2015 12:04 am

Robotic Surgery 24 year old Priya, a nursing staff by profession first noticed a swelling in her neck about 4 years back. The swelling, initially small in size, started increasing gradually and alarmed she met a doctor, who ran some tests. Though the evaluation did not indicate any signs of cancer, the doctor recommended surgery as the nodule by this time was quite large (> 4 cm in size) and growing. Surgery was also the only way to definitely rule out cancer. It would be done through an incision in the neck and would leave a permanent scar. Priya was reluctant to undergo the surgery. Young, pretty and single – a scar in the neck would be psychologically upsetting. She also worried that people would be curious about the scar and question her about what kind of surgery she had. Also Read - Thyroid: Do you constantly feel exhausted? It could be a sign of Hypothyroidism

Luckily for her, robotic surgery came to her rescue. Using the latest generation da Vinci Si robot, doctors at the Apollo Hospitals, Hyderabad removed the right half of her thyroid gland through a small incision in her axilla (arm-pit); in the process avoiding any kind of incision or scarring in the neck. An intra-operative frozen section of the nodule also ruled out the presence of any cancer in the nodule. Due to the robotic technique, Priya recovered fast and was discharged from the hospital within two days following her surgery. She also had minimal discomfort in her neck following the operation and was able to eat and speak the very next day. Priya now has no hesitation in recommending the robotic technique to anyone else who may require a thyroidectomy. Also Read - Have a thyroid disorder? Try these detox drinks to flush out toxins, boost thyroid function

Read more about causes, symptoms, diagnosis and treatment of thyroid disease. Also Read - Suffering from thyroid? Try these 5 effective yoga asanas to get rid of the problem

Robotic Thyroidectomy

The technique of trans-axillary robotic thyroidectomy was first described by Prof Woong Youn Chung, a surgical endocrinologist at the Yonsei University in Seoul, Korea in 2005. The impetus for developing the technique was dictated by the high incidence of thyroid cancers in South Korea. A large number of these patients were young and were reluctant to have a scar on their neck, which a conventional thyroidectomy would result in. Prof. Chung had experimented with the endoscopic technique of removing the thyroid gland from the axilla, but was not happy with it. The procedure was cumbersome and did not offer satisfactory visualization of the thyroid gland. During that time, surgeons were already removing the prostate gland regularly for cancer using the robotic technique with excellent results. Prof Chung devised a special retractor (Chung retractor) to aid in keeping the subcutaneous tunnel created between the axilla and the neck lifted up during the robotic procedure. Between 2005 and 2012, Dr Chung and his team performed over 3,200 trans-axillary robotic thyroidectomies on patients from across all over the world, majority (over 80%) of them for cancer of the thyroid gland. Other than the excellent cosmetic results achieved, Dr Chung also demonstrated the superiority of this technique over both conventional neck and endoscopic techniques in terms of faster recovery and fewer complications.

In the first week of February this year, for the first time in the country, surgeons at the Apollo Hospitals in Chennai and Hyderabad successfully performed a series of ten robotic thyroidectomies through the trans-axillary route for both benign and malignant nodules of the thyroid gland under the supervision and guidance of Prof. Chung. With further experience and awareness, it is expected that this revolutionary technique may be a boon for young patients in India suffering from benign and malignant diseases of the thyroid gland who may wish to have surgery performed without scarring of the neck.

Published : February 18, 2013 2:43 pm | Updated:March 23, 2015 12:04 am

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