Thyroid disorders are widespread, mostly benign, but 5% are malignant, requiring surgery based on factors like cosmetic concerns or compression. Conventional thyroid surgery may leave scars and lead to complications. However, recent advancements have introduced scarless robotic surgery as an innovative alternative, offering several advantages, including minimal scarring, reduced blood loss, enhanced precision, and accelerated recovery.
We spoke to Dr Akshat Malik, Head and Neck Cancer Surgeon, Max Super Speciality Hospital, Saket, New Delhi, who explained scarless thyroidectomy, its benefits, and how it is performed.
Dr Malik said that non-cancerous or benign thyroid swellings may be closely monitored, with surgical intervention considered only when they cause cosmetic concerns or compression of vital neck structures. He added, “For thyroid cancer cases, the course of treatment is influenced by various factors, including age, sex, lesion size, and the presence of lymph nodes or distant metastasis. Surgical options may involve hemithyroidectomy (removing half of the affected gland) or total thyroidectomy (complete thyroid gland removal). Excision of lymph nodes in the neck and chest may also be necessary if they are involved.”
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Complications Of Thyroid Surgery
Dr Malik said, “After thyroid surgery, some common problems can include issues with your vocal cords and hypocalcemia (low calcium levels in your blood). Vocal cord nerve injury during surgery or the necessity to excise it due to disease involvement may result in temporary or permanent hoarseness. Permanent cord palsy occurs in less than 5% of cases. If the blood supply to the parathyroid glands, responsible for calcium balance, is compromised during thyroid surgery, patients may experience hypocalcemia, requiring calcium supplementation. In cases of complete thyroidectomy, lifelong thyroid hormone supplementation may be necessary.”
What Is Scarless Thyroidectomy?
Dr Malik said, “Conventional thyroidectomy typically involves an incision in the neck. In contrast, scarless thyroidectomy is a surgical procedure performed without any visible or apparent neck scars. Access to the thyroid gland is achieved from a distant location, which can be behind the ear, from the chest, or within the mouth.”
According to Karger e-Jorunal 2018, robotic thyroidectomy exhibits superior results compared to open surgery when considering specific patient-reported outcome measures, such as the appearance of scars and pain levels.
How Are These Surgeries Performed?
Dr Malik added, “To reach the thyroid gland from a distance, doctors make certain changes during surgery. They can use special tools that are small and go inside your neck or even use robots to help. Robots are often a good choice because they can be very precise and make it easier to do the surgery.”
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What Is The Advantage Of Robotic Surgery?
- No Visible Scars: Scarless thyroidectomy is performed without making any visible scars on your neck, which can be important for cosmetic reasons.
- Less Blood Loss: It typically involves less bleeding compared to traditional thyroid surgery.
- Enhanced Precision: Surgeons can see and work with great precision, reducing the risk of complications.
- Faster Recovery: Patients often recover more quickly after scarless thyroidectomy.
- Minimal Pain: It can result in less post-operative pain and discomfort.
- Lesser Complications: Due to the enhanced precision and magnified view, there are fewer complications associated with this approach.
- Less Impact on Daily Life: Patients often experience fewer restrictions on their daily activities and diet following scarless thyroidectomy.
How Are These Robotic Surgeries Performed?
Dr Malik informed, “Trained Head and Neck Robotic surgeons perform these surgeries using a surgical robot equipped with small arms that allow for precise instrument placement through smaller incisions and areas. The surgeon operates from a separate console, offering a three-dimensional view of the surgical site, ensuring precise control throughout the entire procedure.”
How Is The Recovery Following These Surgeries?
Dr Malik said, “Following surgery, patients can resume normal activities, eating, and drinking on the same day. A drain may be used temporarily to remove collected blood. Also, there are no dietary or activity restrictions.”
[Disclaimer: This article contains information provided by a registered medical practitioner and is for informational purposes only. Hence, we advise you to consult with your expert for a treatment plan tailored to your requirements.]
