The Learning Curve for Robotic Thyroidectomy Using a Bilateral Axillo-Breast Approach From the 100 Cases

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Purpose:The purpose of this study was to examine the learning curve for robotic thyroidectomy using a bilateral axillo-breast approach.Methods:We examined the first 100 robotic thyroidectomies with central lymph node dissection due to papillary thyroid cancer between April 2010 and August 2011. We evaluated the clinical characteristics, operative time, pathologic data, and complications.Results:Operative time was reduced significantly after 40 cases; therefore, the patients were divided into 2 groups: group A (1 to 40 cases) and group B (41 to 100 cases). The mean operative time in group A (232.6±10.0 min) was longer than that in group B (188.9±6.0 min) with statistical significance (P=0.001). Other data, including characteristics, drainage amount, hospital stay, retrieved lymph nodes, thyroglobulin, and complications, were not different between the 2 groups. The learning curves with lobectomy and total thyroidectomy were reached at the same time.Conclusions:The learning curve for robotic thyroidectomy with central lymph node dissection using bilateral axillo-breast approach was 40 cases for beginner surgeons. Robotic total thyroidectomy was performed effectively and safely after experience with 40 cases, as with lobectomy.

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