Objective:

To evaluate the feasibility and safety of the Carina™ modular robotic system for thyroid surgery.

Approach:

• Study Design: Preliminary prospective, single-arm study involving pre-clinical validation and clinical implementation.
• Patient Selection: Seven patients with papillary thyroid cancer scheduled for endoscopic thyroidectomy underwent gasless transaxillary robot-assisted thyroidectomy.
• Data Collection: Surgical outcomes were analyzed to assess feasibility and safety, including system preparation time, teleoperation time, and operative time.

Key Findings:

• All seven patients underwent successful gasless transaxillary robot-assisted unilateral lobectomy and central neck dissection without conversion to open surgery.
• Mean system preparation time was 10.43 minutes, teleoperation time was 116.14 minutes, and operative time was 196.43 minutes.
• Surgeons reported low physical and mental stress load scores.
• Average number of retrieved central lymph nodes was 6.14 with 1.00 metastatic node.
• Transient paresthesia was the most common complication, with no severe complications observed.

Interpretation:

The Carina™ system appears to be a feasible and safe method for unilateral thyroidectomy with central lymph node dissection in selected low-risk patients.

Limitations:

• Small sample size of only seven patients.
• Short follow-up period to assess long-term outcomes.

Conclusion:

The Carina™ system demonstrates feasibility and safety for thyroid surgery in this initial clinical series.