Robotic Versus Endoscopic Transoral Thyroidectomy with Vestibular Approach: A Literature Review Focusing on Differential Patient Suitability

Purpose of Review The purpose of this study was to evaluate the characteristics of patients who underwent transoral robotic thyroidectomy (TORT) in the worldwide literature, especially in comparative studies with transoral endoscopic thyroidectomy by vestibular approach (TOETVA), to better define the ideal appropriate patient. Recent Findings TORT allows a more precise and complete dissection due to the enlarged and three-dimensional surgical vision and the tremor filtering. Current inclusion criteria for TORT mainly concern ultrasonographically estimated nodules as having a maximum diameter <= 70 mm, the papillary thyroid carcinoma with minimal extrathyroidal extension (T1 to T3) with or without evidence of central lymph node metastasis, and Graves' disease with an estimated volume <= 50 mL. Overall, although TORT requires a longer operating time than TOETVA, it allows for more complex surgical procedures, obtaining better oncological results. A clear definition of the inclusion and exclusion criteria for patients to undergo robotic surgery is essential to obtain the most reliable results in future large comparative and non-comparative studies. The purpose of this review article is to analyze both the main comparative studies between TORT and TOETVA series and those involving cohorts of patients operated by TORT, always paying attention to the inclusion and exclusion criteria adopted.