Robotic transoral thyroidectomy: Total thyroidectomy and ipsilateral central neck dissection with da Vinci Xi Surgical System

Background: Transoral approach for thyroidectomy draws attention recently among the thyroid surgeons, with the merits of cosmetic outcomes and minimal flap dissection. The aim of this study is to demonstrate the details and the steps of transoral robotic thyroidectomy. Methods: We made three incisions in the gingival-buccal sulcus for three 8-mm intraoral ports: one inverted U-shaped 1-cm midline incision approximately 2 cm above the frenulum, and two 0.5-cm lateral incisions near the commissure of lips. An additional 8-mm axilla port was inserted for countertraction and later drain insertion. Results: Right thyroid lobectomy, ipsilateral central neck dissection, and left thyroid lobectomy were performed with preserving recurrent laryngeal nerves and parathyroid glands. There was no development of transient or permanent hypoparathyroidism, vocal cord palsy, postoperative bleeding, or surgical site infection. Conclusion: Transoral robotic total thyroidectomy and ipsilateral central neck dissection using the da Vinci Xi Surgical System are feasible and safe.