The Intraoperative Use of a Drain Line for Gas-Insufflation One-Step Single-Port Transaxillary (GOSTA) Robotic Thyroidectomy

Objective: This study aimed to evaluate the intraoperative use of a drain line for smoke suction during robotic thyroidectomy using a gas insufflation one-step single-port transaxillary (GOSTA) approach and its impact on surgical outcomes.

Study design: Retrospective cohort study.

Setting: University tertiary care facility.

Methods: A comprehensive retrospective analysis was conducted in patients divided into 2 groups: the Drain group, where a drain line was directly inserted into the surgical space during surgery (n = 53), and the Control group (n = 83). The 2 groups were compared in terms of perioperative surgical outcomes, including operative time, number of endoscope cleaning, and the number of patients with endoscopes that did not require cleaning.

Results: The operative time was significantly shorter in the Drain group than in the Control group (P = .003). The number of endoscope cleaning procedures was considerably lower in the Drain group (P < .001), indicating a decreased need for endoscope cleaning during surgery. Moreover, a higher number of patients with endoscopes that did not require cleaning were observed in the Drain group (P = .001), suggesting a potential benefit in maintaining endoscope clarity.

Conclusion: These results suggest that using smoke suction with a drain line directly inserted into the surgical space in robotic thyroidectomy using the GOSTA approach may offer advantages such as reduced operative time and improved endoscope clarity.