Robot Modified Radical Neck Dissection (MRND) for Thyroid Cancer with Lateral Neck Node Metastasis using da-Vinci Xi

Abstract

Abstract Background The Modified Radical Neck Dissection (MRND), a surgery for metastatic lymph nodes in the lateral neck area, requires a 15-20cm long incision on the neck. However, with the introduction of robotic surgery, MRND without leaving any scars on the neck became possible. In this video, we will report on a case of MRND using da-Vinci Xi. Methods A 58-year-old female patient was diagnosed with left papillary thyroid cancer and left lateral cervical lymph node metastasis and was referred to our hospital. Total thyroidectomy and bilateral central and left MRND using the robotic bilateral axillary breast approach (BABA) method were performed. Results Total operation time was 210 minutes, with robot console time was 172 minutes. No vocal cord palsy or transient hypoparathyroidism was observed. Patient was discharged on the third postoperative day. In the pathologic results, main tumor was 1cm in left thyroid gland and four microcarcinomas were identified. Metastatic lymph nodes were found in 5 out of 45 lymph nodes. TSH stimulated thyroglobulin level before the radioactive iodine therapy was below the 0.2ng/ml. Conclusion Robotic MRND can minimizes surgical scars on patient’s neck compared to conventional transcervical MRND. For minimally invasive robotic neck surgery to be widely performed, appropriate robot surgery training for surgeons is essential.

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