Robotic versus Endoscopic Thyroidectomy for Thyroid Cancers: A Multi-Institutional Analysis of Early Postoperative Outcomes and Surgical Learning Curves

Table 5

Published data for surgical learning curves for robotic thyroidectomy.

Author, year	Study design	No. (patients)	Approach	Pathology	Operation	Operation time	Complications (Major)*	Methods for analysis	Surgical learning curve for robotic thyroidectomy
Kang et al. (2009) [5]	Retrospective; (single surgeon)	338	GT∗∗	PTC^§ (332); Benign (6)	TT^§§ & CCND^# (104); LTT▵& CCND (234)	Total: 144.0 ± 43.5; Console: 59.1±25.7	5/338 (1.5%)	Moving average	RT^## (Console time): 40–45 cases
Lee et al. (2011) [9]	Retrospective; (single surgeon)	163	GT	PTC (151); FTCγ (1); Benign (11)	TT (48), LTT (115); CCND (149)	Total: 110.1 ± 50.7; Console: 50.9 ± 11.4	2/163 (1.2%)	Moving average	RT: 35-40 cases,; ET▵▵:50–60 cases
Lee et al. (2011); [13]	Prospective; (multicenter study)	644	GT	PTC (616); FTC (13); Benign (15)	TT & CCND (353); LTT & CCND (291)	Total: 181.5 ± 78.2; (≤50^γ γ)→141.5 ± 33.0 (>50); Console: 50.9 ± 11.4	2/644 (0.3%)	Comparative analysis between beginners and experience surgeons	RT (LTT): 40 cases; RT (TT): 50 cases
Kandil et al. (2012) [16]	Prospective; (single surgeon)	100	GT	No data	TT (22); LTT (69); CT^√ (9)	Total: 121.9 ± 63.8; (≤45^√ √)→104.2 ± 71.5 (>45); Console: 51.3 ± 31.1 (≤45); →45 ± 36.4 (>45)	1/100 (1.0%)	Comparative analysis between early experience and late experience	RT: 45 cases

Complications (Major)*: major complications mean permanent damages such as recurrent laryngeal nerve injury, permanent hypocalcemia, hematoma of muscle flap need to reoperation, hemorrhage of a major vessel need to reoperation, trachea injury, Honor’s syndrome, major chyle leakage, and brachial plexus neuropraxia (not including minor complications such as transient hypocalcemia, transient hoarseness, wound seroma, wound infection, and hematoma of muscle flap only need to conservative management), GT**: gasless transaxillary approach, PTC^§: papillary thyroid carcinoma, TT^§§: total thyroidectomy, CCND^#: central compartment node dissection, RT^##: robotic thyroidectomy, LTT▵: less than total thyroidectomy, ET▵▵: endoscopic thyroidectomy, FTC^γ: follicular thyroid carcinoma, ≤50^{γ γ}: experience for robotic thyroidectomy were less than 50 cases, CT^√: completion thyroidectomy, ≤45^{√ √}: experience for robotic thyroidectomy was less than 45 cases.