Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy

Thyroid cancer is a common endocrine disease, and surgery is the most important means of treating thyroid cancer. Thyroid surgery and postoperative complications have been increasing in recent years. Among them, recurrent laryngeal nerve (RLN) injury is a common complication after thyroid surgery, which is mainly manifested as paralysis of the vocal cords and respiratory difficulties, negatively affecting the quality of life of patients. In recent years, with the continuous development of the concept of minimally invasive technology, we introduced a robotic surgical system into thyroidectomy via the oral vestibular approach and used a combination of blunt and sharp detachment to explore the RLN without the aid of an RLN monitor. Identification and protection of the RLN were successfully accomplished along with thyroid lobectomy and ipsilateral central lymph node dissection. Follow-up observations were conducted 1 week, 1 month, and 6 months after surgery to assess patient recovery. Overall, using this method in robotic thyroidectomy via the oral vestibular approach helped the operator quickly explore and protect the RLN, decreasing the occurrence of postoperative complications.