{
    "abstract": "In the past 20 years, the fast spread of new surgical technologies has reached an important peak with the advent of the robotic surgery. Many studies have been run about a cosmetic desire to avoid neck scars after thyroid surgery and this has led to the development of remote access robotic thyroidectomy (RT). Among the various RT approaches, unilateral transaxillary access is one of the most widely used, reporting excellent results in terms of feasibility and patient's compliance. The mini-invasive technique demonstrated many potential shortcoming overcomes with the robotic approach. At our institution a team of 3 skilled endocrine surgeons with experience in laparoscopic and robotic procedures performed RT. Our aim is to report our 8-year single-centre robot-assisted thyroidectomy experience, by applying a gasless unilateral transaxillary approach with the so-called hybrid technique, and to demonstrate its safety and feasibility.\nIn the period between September 2010 and June 2018 at our institution, a total of 472 patients underwent thyroid and parathyroid transaxillary surgery. The hybrid technique was applied for all the robotic procedures. A total of 412 procedures were performed with the use of external \"Modena Retractor\" (CEATEC\nIn this series, a total of 449 cases were registered. General data of patients were analyzed: gender, age, body mass index, tumor size, preoperative fine-needle aspiration examination, definitive histological examination, operative time, and postoperative complications.\nThis study confirms the application of robotic approach in thyroid surgery as a feasible technique in terms of safety and complications risk. The hybrid technique, together with a dedicated surgical team, can lead to obtaining the same outcomes of traditional anterior cervicotomic surgery, adding a scarless thyroidectomy.",
    "authors": [
        {
            "affiliation": "1 Department of General and Emergency Surgery, Azienda Ospedaliero-Universitaria Modena, Modena, Italy.",
            "firstname": "Micaela",
            "initials": "M",
            "lastname": "Piccoli"
        },
        {
            "affiliation": "1 Department of General and Emergency Surgery, Azienda Ospedaliero-Universitaria Modena, Modena, Italy.",
            "firstname": "Barbara",
            "initials": "B",
            "lastname": "Mullineris"
        },
        {
            "affiliation": "1 Department of General and Emergency Surgery, Azienda Ospedaliero-Universitaria Modena, Modena, Italy.",
            "firstname": "Davide",
            "initials": "D",
            "lastname": "Gozzo"
        },
        {
            "affiliation": "1 Department of General and Emergency Surgery, Azienda Ospedaliero-Universitaria Modena, Modena, Italy.",
            "firstname": "Giovanni",
            "initials": "G",
            "lastname": "Colli"
        },
        {
            "affiliation": "1 Department of General and Emergency Surgery, Azienda Ospedaliero-Universitaria Modena, Modena, Italy.",
            "firstname": "Francesca",
            "initials": "F",
            "lastname": "Pecchini"
        },
        {
            "affiliation": "2 General Surgery Department, Torvergata University, Rome, Italy.",
            "firstname": "Casimiro",
            "initials": "C",
            "lastname": "Nigro"
        },
        {
            "affiliation": "3 Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.\n4 Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.",
            "firstname": "Vincenzo",
            "initials": "V",
            "lastname": "Rochira"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": "10.1089/lap.2019.0021",
    "journal": "Journal of laparoendoscopic & advanced surgical techniques. Part A",
    "keywords": [
        "Modena retractor",
        "robotic",
        "thyroidectomy",
        "transaxillary"
    ],
    "methods": null,
    "publication_date": "2019-03-06",
    "pubmed_id": "30835159\n11923603\n19562360\n19879615\n21857470\n19263137\n20490558\n23239293\n21253726\n26530969\n26891534\n26808320\n24783047\n27069476\n9266657\n19632588\n23025541\n23158176\n23700070\n26980907\n24648108\n24271160\n26858014\n27294043\n26525401\n28680769\n23008331\n26425452\n23158175",
    "results": "In this series, a total of 449 cases were registered. General data of patients were analyzed: gender, age, body mass index, tumor size, preoperative fine-needle aspiration examination, definitive histological examination, operative time, and postoperative complications.",
    "title": "Evolution Strategies in Transaxillary Robotic Thyroidectomy: Considerations on the First 449 Cases Performed.",
    "xml": "<Element 'PubmedArticle' at 0x7885040e4ea0>"
}