[vanillasky]

#1059486

My new endocrinologist at Cleveland Clinic Foundation says he has a new technique of doing surgery and removing the thyroid robotically and he claims it is scarless. He did not elaborate about it because he said we have to take it one step at a time, but if I do end up with surgery, he claims there will be no scar to worry about. I do not understand this. I have known people to have rather long scars on their necks. Has anyone had TT robotically?

[snelsen]

#1175048

This is not really an answer to your question, but I had a TT, and my incision is not visible. My personal thought is, that I prefer to have an incision if given the option, because I want the surgeon to really see and identify all the things that need to be seen to be avoided.
It is possible that they have a way to do it laparascopically, with a camera.
I would ask more questions when the time comes for you to consider this.
Shirley

[emmamarston37]

#1175049

I think you might be right Snelsen, though I doubt they will be laproscopic as that involves going through the belly… seems a long way to travel . Endoscopic though possibly.

As far as I know, there are techniques that are purely endoscopic or video-assisted that are relatively new forms of surgery. I’d argue that you will still have a scar, it would just be smaller and perhaps not located on your neck, meaning it may be easier to hide. People who have the normal thyroid surgery sometimes have large, visible scars on their necks, but not everyone does. I guess it is up to you to decide whether this could be a problem for you.

Whether or not you are suitable for this type of surgery though will depend on a lot of different things; the size and position of your thyroid gland are just 2 of these. This is probably why your endocrinologist was a bit vague.

Hope this helps

[vanillasky]

#1175050

I finally got information about it. They go through the armpit! Can you believe this?

[Kimberly]

#1175051

Hello – This is definitely an issue where you will want to do your research before making a decision. The last two thyroid surgeons who have presented at our conferences are not fans of the robotic approach. They feel that even though the scarring is not as visible, you actually have to work your way through *more* tissue to get from the initial incision in the armpit to the thyroid gland.

Also, as I recall, there were some concerns about FDA approval for this particular robotic device being used to perform thyroid surgery.

Not to say this isn’t an option — just make sure you ask lots of questions and understand any risks involved.

Take care!

[gatorgirly]

#1175052

I initially opted for surgery, and it was going to be performed by an otolaryngology surgeon who specialized in thyroidectomies at a major university teaching hospital in Florida. He performs some thyroidectomies through the armpit and has obviously had success with that approach. In the end, I chose RAI for a number of reasons, but none had anything to do with him or his approach. In fact, I was drawn to that approach and considered a good candidate because I get keloid scars so a traditional thyroidectomy would not have been ideal for me.

Granted, this was all back in 2010. Now, in doing a search for da Vinci thyroidectomy videos, I get nothing that isn’t at least a year old. And their website no longer lists thyroid surgeries, so maybe the FDA approval was withdrawn…? That’d be too bad, because TT was basically taken off the table for me when my first surgeon found out I get keloids. Silly reason not to be allowed surgery if you are strongly opposed to ATDs or RAI!

[PolishTym]

#1175053

I had the usual kind of surgery and you’d have to be too close for my comfort to think you may see a scar.

Our resident experts can offer if surgeons vary a lot in reducing the size and duration of scars.

[snelsen]

#1175054

to emmamarston37-you are SO RIGHT! I was so tired when I wrote, that I said the wrong “scopic!” Yes, that would be quite a journey!

To gatorgirly-sure agree that the reason you were given is a pretty dumb and judgemental one, to exclude surgery as an option. Keloids also depend on skin color, and sometimes, the surgeon.

Even if you did get too close for comfort, I doubt if someone could see my incision! (:
Shirley

[mhanscom]

#1175055

I wanted to reply to this message because my surgeon is the top Head and Neck Dr. at USC. He asked me if I wanted to use the robotic way or traditional. I asked him the pros and cons. He said the scar was the only real good pro. He explained that by going through the armpit must be dome 2 separate surgeries because they can not cross the mid line muscle. He said it is about a 2.5hr surgery for each side so 5+ hrs under general. Beside he sad that my chest muscles would be super sore. He did say that he could use the robot and make 2 vertical lines in the side of the neck, but that would show just as much as the line across. He sad that the line he makes is so little and the stitches are so tiny that the line becomes invisible over the next few months.

Needless to say I had my TT 2 days ago in the traditional manner. He used a laser to cut and cauterize at the same time. My vocal nerves and parathyroids are all intact with no damage.
I have about an 1.5 inches of stitches with glue over it. He sad the glue is to keep the line nice and tight while it heals since it is at a bendy place. The glue will dissolve in a few days and so will the stitches.

Being able to ask the #1 and know what he personally would do was the best comfort for me. He would have done what I wanted but the personal advice I felt was the best. He communicates with me by email and by texting and he has already checked up on me today.

Hope this helps someone else decide.

[snelsen]

#1175056

mhanscom, you sure had a great surgeon! So happy for you. Asking the pros and cons is a very good idea! This is not something to decide to do (the armpit way) with the decision based on no neck scar. I do believe the traditional way is also safer, for they can really SEE the field.
It will be interesting to see how this procedure is accepted, both by surgeons and patients. Also, this is very new, so no surgeon probably has much experience with it. I see the long anesthesia as another con.
Glad you are doing so well!!!!
You gave really advice for others who are considering this option. For sure, it should be a surgeon with as much experience as possible if it is chosen.
Shirley

[Carito71]

#1175057

Hello.

Here is a link from the Mayo Clinic regarding this type of TT.

http://www.mayoclinic.org/medicalprofs/robotic-thyroidectomy-new.html

Hope this helps.

[Author]

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