Surgery for Graves' disease in the era of robotic-assisted surgery: a study of safety and feasibility in the Western population

Langenbecks Arch Surg. 2018 Nov;403(7):891-896. doi: 10.1007/s00423-018-1713-y. Epub 2018 Sep 29.


Purpose: Thyroid surgery for Graves' disease is known to be associated with higher risk of complications. We seek to compare outcomes between robotic-assisted and open cervical approach thyroid surgery in patients with Graves' disease in the Western population.

Methods: We performed a retrospective cohort study using prospectively collected databases for patients undergoing robotic-assisted or conventional cervical approach thyroid surgery for Graves' disease at two academic medical centers, one in North America (New Orleans, LA) and one in Europe (Paris, France).

Results: A total of 102 patients were included, of which 56 (55%) underwent robotic thyroidectomy and 46 (45%) underwent conventional open cervical thyroidectomy. Mean age was 40.2 ± 13.2 years and 94 (92%) were females. Mean BMI for the sample was 27.7 ± 10.2 kg/m2. There was a trend towards larger specimen volume in the robotic-assisted group, 84.9 ± 62.2 cm3 versus 65.2 ± 40.5 cm3 (p = 0.07). Mean length of stay for the French patients undergoing robotic-assisted surgery was 3.2 ± 0.5 days. For the American cohort, length of stay was significantly shorter for robotic-assisted thyroidectomy, at 0.8 ± 0.4 days versus 1.0 ± 0.2 days (p = 0.003). Operative time was longer in patients who underwent robotic thyroidectomy (174.4 ± 33.5 min) compared to patients who underwent traditional cervical approach (121.2 ± 41.1 min, p < 0.0001). There was no difference in complication rates for the overall sample of patients undergoing robotic-assisted or open cervical procedures.

Conclusion: Robotic thyroid surgery is safe in a select group of patients with Graves' disease in the Western population. Additional studies are warranted to further investigate these findings.

Keywords: Graves’ disease; Hyperthyroidism; Robotic-assisted surgery; Surgical outcomes.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Academic Medical Centers
  • Adult
  • Aged
  • Chi-Square Distribution
  • Cohort Studies
  • Databases, Factual
  • Feasibility Studies
  • Female
  • France
  • Graves Disease / diagnosis
  • Graves Disease / surgery*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Normal Distribution
  • Operative Time
  • Patient Safety*
  • Patient Selection
  • Postoperative Complications / epidemiology
  • Postoperative Complications / physiopathology
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Robotic Surgical Procedures / adverse effects
  • Robotic Surgical Procedures / methods*
  • Severity of Illness Index
  • Thyroidectomy / adverse effects
  • Thyroidectomy / methods*
  • Treatment Outcome
  • United States