Transoral Robotic Thyroid Surgery: Technical Considerations

Recently, many surgeons worldwide have adopted the transoral thyroidectomy approach owing to the associated advantages of less surgical morbidity, excellent cosmesis, and superior postoperative vocal outcomes. Specifically, transoral robotic thyroidectomy, in which a surgical robot is used, has been performed to hide or avoid visible neck scars and overcome the limitations associated with the endoscopic procedure. The transoral robotic thyroidectomy technique involves creation of three oral vestibular incisions and use of an additional axillary port, if indicated. Transoral robotic thyroidectomy is feasible and comparable to conventional transcervical thyroidectomy for highly selected patients. However, some unusual complications, such as CO2 embolism, mental nerve injury, surgical site infection, and skin burn and trauma, are noted. Appropriate patient selection is important for the safety and success of this surgery.