Porcine Model for Open Robotic Thyroidectomy

Background: Well-defined, simple surgical models are useful in translational research in that they provide real world scenarios to evaluate novel technologies. Open porcine thyroidectomy has been used for several decades as a model to study nerve injury in thyroid surgery, but published anatomic descriptions are many decades old. In recent years, experience in robotic thyroidectomy surgery has led to refinements in approach and technique in humans. We present a contemporary review of porcine thyroidectomy with a novel description of an open robotic surgical approach. Methods Porcine cadaveric anatomy study. Results The porcine infrahyoid musculature is comparable to humans. The primary arterial supply to the thyroid gland comes from the thyroid artery, a branch of the omocervical artery. Thyroid veins can also be identified bilaterally. There is a single thyroid lobe located anterior to the trachea with two parathyroid glands. Open robotic thyroidectomy is described using two instruments (grasping forceps and monopolar cautery) and standardized surgical steps are defined. Dissection around the thyroid parenchyma requires mobilization of prominent thymus tissue. The recurrent laryngeal nerve in the tracheoesophageal groove is separate from the thyroid parenchyma. Conclusion Porcine thyroid anatomy is similar to humans. A key difference is the separation between the thyroid parenchyma and the recurrent laryngeal nerves. The ease of setup, access, and simplicity of instrument manipulation makes open robotic porcine thyroidectomy advantageous for translational research purposes. Characterizing the anatomy and defining the surgical steps may help standardize future research efforts toward open, robotic, and minimal-access thyroid surgery.