Modified Approach for Robotic Retroauricular Thyroidectomy: Preclinical Simulation and a Surgical Case

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Background. Recently, a single remote access retroauricular robotic technique has been described for thyroid lobectomy. We aimed to explore the feasibility and safety of modifying this novel approach using preclinical cadaver model followed by performing the same operation in a real patient. Methods. The modified retroauricular approach was performed by creating a working space between the 2 heads of the sternocleidomastoid muscle, instead of that anterior to muscle. This was performed to create a wider working space. Two operations were initially performed in human cadavers. Subsequently, robotic-assisted thyroid lobectomy was performed using this novel modified retroauricular approach. Results. Robotic-assisted hemithyroidectomy was performed successfully in 2 cadavers and subsequently in one patient using modified approach. The patient was discharged on the same day of surgery and had no complications. Conclusions. The modified retroauricular approach with creation of a working space between the 2 heads of sternocleidomastoid muscle is safe and feasible, and offers a wider working space for robotic thyroid surgery.

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