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Report of a Track Seeding of Thyroid Papillary Carcinoma During Robot- Assisted Transaxillary Thyroidectomy

Emilien Chabrillac, Slimane Zerdoud, Pierre Graff-Cailleaud, Sébastien Fontaine and Jérôme Sarini

Background: The Robotic Thyroidectomy (RT) is a minimally invasive surgical technique initially developed in Asia, for cultural reasons. The principles of its use are still undergoing development. Showing to all appearances satisfying outcomes, the long-time safety and medico-economic benefit of the procedure have not been established yet. The use of this technique in thyroid carcinology remains rare, and provides specific risks, not encountered with the Open Thyroidectomy (OT).

Patient Findings: We report the case of a patient who underwent a two-stages RT for a pT3 follicular carcinoma causing dissemination along the surgical track, in spite of the radioactive iodine treatment.

Summary: This case reminds us the limits of the RT in the oncologic field and the lack of perspective, with the recent discovery of the risk of dissemination along the surgical track. Our synthetic review of the literature comparing RT to OT shows the advantages and limitations of the RT.

Conclusions: The development of the RT should pursue its way, but the use of this procedure in thyroid carcinology must remain reasonable. Further data is necessary to assess the long-term oncologic safety, regarding even the uncommon risks, as the track seeding. To this day, OT remains the gold standard for the complex thyroid pathologies.