Transoral endoscopic thyroid surgery using robotic scope holder: Our initial experiences
Jun-Ook Park1, Mi Ra Kim2, Yeong Jun Park2, Min-Sik Kim3, Dong-Il Sun3
1 Department of Otolaryngology Head and Neck Surgery, College of Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
2 Department of Otolaryngology Head and Neck Surgery, College of Medicine, Haeundae Paik Hospital, Inje University of Korea, Busan, South Korea
3 Department of Otolaryngology Head and Neck Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
Department of Otolaryngology Head and Neck Surgery, Seoul St. Mary's Hospital, 222, Banpo-Daero, Seochogu, Seoul, 06591
Source of Support: None, Conflict of Interest: None
Background: Transoral thyroid surgery represented by the da Vinci system is attracted attention and performed by several institutions. However, the current available da Vinci system still has some limitations to be improved for transoral thyroid surgery including high cost of equipment and expendables, larger diameter scope and instruments and no tactile sensation. It triggered us interest in more easily available robotic scope holder. Soloassist II (AktorMed GmbH, Barbing, Germany) is an active endoscope holder system which is controlled by a joystick. It has total six joints: three joints which are controlled by computer, one is controlled by manual and two act as a gimbal joint following the movement of the main body.
Materials and Methods: We tried transoral endoscopic thyroidectomy using Soloassist II (AktorMed GmbH, Barbing, Germany) in December 2017 in our hospital.
Results: We successfully performed four thyroid lobectomies in four patients with Soloassist II. We refined and described surgical procedures in each step using video clips. It provided an excellent vibration-free stable surgical view which enabled fatigue-free work, without shaking or tilting the horizon. The surgeon could perform transoral endoscopic thyroid surgery with only one assistant surgeon. Docking and preparation time for Soloassist was within 10 min in all four patients. The setup and dismantling could be performed parallel to the usual workflow. No complication was reported by any patient.
Conclusions: The robotic scope holder (Soloassist II) seems to be safe and feasible equipment for performing transoral endoscopic thyroid surgery. Several possible advantages could be expected with this robotic scope holder.