# Comparison of Transoral Robotic Thyroidectomy and Transoral Endoscopic Thyroidectomy via Vestibular Approach Using an Endoscopic Retractor: A Single-Center Experience

## TL;DR

This study compares two scar-free thyroid cancer surgeries through the mouth, finding both safe and effective, with robotic surgery offering more precision but at a higher cost.

## Contribution

The study provides a direct comparison of robotic and endoscopic thyroidectomy techniques with a focus on cost and precision trade-offs.

## Key findings

- Both robotic and endoscopic thyroidectomy methods showed similar surgical outcomes and safety.
- Robotic surgery offers better precision but is significantly more expensive.
- Endoscopic thyroidectomy is a cost-effective alternative for patients.

## Abstract

This study compares two scar-free thyroid cancer surgeries performed through the mouth—one using an endoscope and the other using a robotic system. All surgeries were performed by a single experienced surgeon using a specialized retractor. Both methods were found to be safe and effective, with similar surgical outcomes. While robotic surgery offers better precision, it is significantly more expensive. Therefore, the endoscopic approach can be a strong alternative for patients seeking safe, cost-effective treatment. These findings may help guide future choices in thyroid cancer surgery and expand options for patients.

Background/Objectives: The TOETVA and TORT have been successfully refined in recent years, with few complications and excellent results. In this study, we compared TORT and TOETVA in patients with papillary thyroid cancer. Methods: From September 2016 to January 2022, we retrospectively compared patient characteristics and clinical features from 100 TORT cases and 300 TOETVA cases, as well as their respective learning curves. Results: Median operation time of TORT was 80.4 min, similar to TOETVA (81.4 min, p = 0.719). Median docking time of TORT was 4.51 min and median console time was 27.72 min. The length of stay of TORT and TOETVA was 2.29 and 2.54 (p = 0.002). The median number of retrieved central lymph nodes for TOETVA and TORT were 2.89 and 2.99 (p = 0.746). Discussion: There was no significant difference with clinical features between TORT and TOETVA.