Robotic thyroidectomy, or removal of the thyroid gland using robotic techniques. Also known as RATS, Robotic Assisted Thyroid Surgery. This surgery was pioneered in South Korea and it became main stream with hundreds of procedures performed each year. There is apparently a cultural perception with regards to scars in the neck, this makes this procedure extremely popular.

 

In other countries such as USA or Australia it has not taken off as anticipated. The reasons behind this are multiple and we will talk about them in the following lines. RATS uses a long incision in the axilla, around 6cm, this makes the procedure invasive and does not have the benefits of minimally invasive surgery. Patients need to stay longer in hospital by longer it is only 2 or 3 days, but when compared with conventional thyroid surgery where every patient goes home the next day it is difficult to justify. The only apparent benefit is the absence of a scar in the neck...Does this have the same implications as it does in countries like South Korea? Also RATS comes with a higher fee, the so-called "technology fee" that at present is around $4000.

 

The Americans have left the procedure aside due to a combination of these aforementioned factors and other issues related to approval linked to the robotic technology. After receiving 13 reports of complications, Intuitive Surgical, the company that manufactures the robot, decided it could no longer support the use of its robot for thyroid surgery. 

 

In Australia the procedure has been introduced by the Macquarie Head and Neck Surgery Unit, however only a handful of procedures have been performed. It is unclear at this stage where is this great technology going to take us with regards to performing thyroid surgery. 

 

Dr. Nicolas Oddone-Baridon