0
Correspondence |

Are Bilateral Axillary Incisions Needed or Is Just a Single Unilateral Incision Sufficient for Robotic-Assisted Total Thyroidectomy?—Reply

Nancy D. Perrier, MD
Arch Surg. 2011;146(2):241. doi:10.1001/archsurg.2010.324.
Text Size: A A A
Published online

Extract

In reply

We would like to thank Kandil et al for taking the time to comment on our case report. We support their call for a judicious and safe approach to preventing neuromuscular complications by use of robotic-assisted transaxillary surgery.

To that end, it was our conscious decision not to proceed with total thyroidectomy through a unilateral single incision. We do not feel that a unilateral approach is appropriate for our patient population. We have personally observed Dr Chung's procedure and have reviewed his data, which were provided to us by Dr Ryu and others. We recognize that the experience described is that of the Korean population. This population, in general, has a much smaller body mass index and body habitus than that of our American cohort. In our patients, we feel that adequate reflection of the contralateral lobe and safe exposure of the contralateral recurrent laryngeal nerve are not possible through a unilateral incision. We are concerned that the contralateral resection will not adequately remove all the thyroid tissue. As such, it would not be an ideal approach for either malignancy or treatment of hyperthyroidism. For those who pursue total thyroidectomy, we suggest the use of postoperative radioactive uptake scans, ultrasonographic examination, and videostroboscopy, to ensure and document the removal of all thyroid tissue, and postoperative monitoring of the recurrent laryngeal nerve.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

February 1, 2011
Emad Kandil, MD; Mohamed Abdel Khalek, MD; Michael Thomas, MD, PhD; Charles F. Bellows, MD
Arch Surg. 2011;146(2):240-241. doi:10.1001/archsurg.2010.323.
CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();