Mount Sinai Surgeons Remove Cancerous Lymph Nodes Using Novel Robot-Assisted Procedure

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A team of surgeons at Mount Sinai Beth Israel, led by Hyunsuk Suh, MD, Assistant Professor in the Department of Surgery at the Icahn School of Medicine at Mount Sinai, has performed the first robot-assisted radical neck dissection in the United States using the bilateral axillo-breast approach, a surgery that involves removing all of the lymph nodes on one side of the neck. The results were published in the journal Video Endocrinology.

Dr. Suh and the endocrine surgery team at Mount Sinai are reportedly the only surgeons in the country currently utilizing the bilateral axillo-breast technique to treat benign and malignant thyroid disorders. His current study explores the use of bilateral axillo-breast approach to remove metastatic cancer in the lateral neck. The bilateral axillo-breast technique entails the surgeon making two incisions along each areola and two incisions in the skin creases of the armpit. Robotic instruments, including an endoscope, are then inserted into the incisions. Once a working space within the neck area is created, Dr. Suh preserves the critical structures before removing the diseased lymph nodes or thyroid gland. This minimally invasive procedure leaves a hidden scar compared with the conventional approach, where the surgeon makes an incision on the neck.

Dr. Suh says the use of the robotic platform provides excellent visualization of anatomic structures, and the robotic instruments allow for safer and more accurate maneuvers. Dr. Suh has performed 40 robotic thyroidectomies at Mount Sinai Beth Israel and studied the bilateral axillo-breast approach at Seoul National University Hospital in South Korea, where the procedure was developed.

“Surgical innovations must entail safe and sound outcomes as well as added benefits to the patients. Robotic thyroidectomy is yet a [U.S. Food and Drug Administration] off-labeled procedure in the United States, but through ongoing advancement and proper implementation, [bilateral axillo-breast] technique will have a great impact in the field of thyroid surgery,” according to Dr. Suh. ■




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