In 1923, Charles H. Mayo, MD, reported to the American Surgical Association the development of a safe thyroid operative technique that was grounded in attention to detail and avoidance of technical errors. With his technical standardization, morbidity and mortality rates for thyroidectomy, especially in Graves disease, were reduced to a minimum of less than 0.6%.1 Almost a century later, Dr Mayo’s technique is still consistently performed with reproducible results. Despite its consistent safety, new technologies have evolved and distant-access thyroid resection techniques have been pursued. Innovative approaches via the axilla, retroauricular region, breast, and oral cavity began to proliferate in 2009, mainly outside of the US. The main advantage has been a more desirable cosmetic outcome. The initial North American experiences were subject to considerable criticism for the relatively high rate of complications and significantly increased use of resources.2,3 Today, interest in all but the transoral approach has dwindled. Studying surgical techniques that are potentially more efficient is important, but until proven to be better, it is necessary that distant-access thyroidectomy be used sparingly and judiciously.4
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Perrier ND, Angelos P. Distant-Access Robotic Thyroidectomy—Is It Worth the Cost? JAMA Surg. 2020;155(11):1010–1012. doi:10.1001/jamasurg.2020.1491
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