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The application of adrenal surgery has been spreading steadily in recent years. With the increased use of robotics in surgery, robotic adrenalectomy (RA), especially for the posterior retroperitoneoscopic approach, has been taken on by many high-volume institutions as a good option over the standard laparoscopic approach (LA). This paper reviews the recent literature from May 2010 up to November 2019 with the aim of analyzing RA complications in order to identify risk factors for complications after RA. We analyzed 7 principal risk factors for complication body mass index (BMI), age, tumor size, tumor side, pathology, previous surgery, and surgeon experience. In the review, some studies identified tumor size, malignancy type, completion of learning curve and, and less clearly, previous ipsilateral upper mesocolic or retroperitoneal surgery, as risk factors for postoperative complications and failure of robotic surgery. Whether RA is meaningfully superior to the standard minimally invasive approach is still a subject of discussion. RA appears safer by virtue of its reduction in hospital stay, lower blood loss, and equivalent complication rates, and surgeons should prefer adrenalectomy over the LA. Despite these advantages, the operative time and the overall cost of the robotic procedure are higher than the LA. Further high-quality trials, especially those analyzing the specific risk factors for complications in robotic surgery, should be conducted in order to optimize the stratification of patients eligible for robotic surgery.

With increased utilization of robotic technology, robotic adrenalectomy (RA) became popular in certain high-volume centers as an alternative to conventional laparoscopic adrenalectomy (LA). The aim of the present study was to evaluate clinical and surgical outcomes of RA in two high-volume centers in Turkey.

Between 2012 and 2019, consecutive patients who underwent robotic transperitoneal adrenalectomy in two referral centers for surgical endocrine diseases in Turkey were analyzed retrospectively.

A total of 111 patients were analyzed. Mean diameter of the tumor in preoperative imaging was 38.6±2.0 mm. Total operation time was 135.4±47.9 min. The analysis of the learning curve period and the post-learning curve period in both centers demonstrated that the total surgery time decreased from 152.68±48.6 to 118.8±37.1 min, and the console time decreased from 113.2±38.9 to 81.6±35.1 min (P<0.0001). In 8 patients, complications arose during the surgery and postoperative complications were observed in 10 patients. Intraoperative complication rate was 28% in patients with a tumor diameter of greater than 50 mm (P<0.0001). There was no mortality.

Our study demonstrated that RA is a safe and effective procedure with low-morbidity and without mortality in high number of cases.

Our study demonstrated that RA is a safe and effective procedure with low-morbidity and without mortality in high number of cases.Ectopic thyroid rarely occurs in the thoracic or abdominal cavity, especially in the lung. Here, we describe an intrapulmonary thyroid tissue case in bilateral lung lobes without thyroid malignant history, which was found during a routine physical examination. A 37-year-old Chinese female showed multiple pulmonary nodules appearing in bilateral lung lobes on a computed tomography (CT) scan during a routine medical examination. To rule out the possibility of lung metastasis from occult cancer, a percutaneous lung biopsy was performed on a larger nodule. Histopathological examination confirmed that the nodule was completely consistent with normal thyroid tissue, which prevented the patient from requiring any unnecessary treatment. During the patient's follow-up, there was no abnormal thyroid function, and there was no change in the size of the nodule in the lung during serial CT scan. Currently, there is no guidance or consensus on the diagnosis of ectopic thyroid with bilateral multiple pulmonary nodules due to its rarity in clinical practice. https://www.selleckchem.com/products/YM155.html When such pulmonary nodules are encountered, very careful diagnosis and follow-up should be performed.We report a patient with right substernal goiter and preoperative vocal cord palsy (VCP). During dissection, an anatomic variation of the recurrent laryngeal nerve (RLN) and a prolonged EMG were detected by intraoperative neuromonitoring (IONM). Symmetrical vocal cord movement was recorded one month after surgery. The potential for recovery of vocal cord function is high after surgical treatment of a thyroid tumor with preoperative VCP. An IONM enables early localization of the RLN position. To the best of our knowledge, this case of prolonged EMG in an abnormal acquired-ventral RLN trajectory is the first reported in the literature.As the high-pace development of sonography in recent years, the incidence of papillary thyroid carcinoma (PTC) has increased sharply worldwide, especially papillary thyroid microcarcinoma (PTMC). As we all know, PTMC is an indolent tumor, and level I lymph nodes (LNs) at a higher region relatively, so the majority of PTMCs admitted to surgery before the level I LNs metastasis. It is rare to see PTMC with level I LNs metastasis. At best of our known, there is only one Chinese research mentioned it but without a description of it. In this case, we reported a 30-year-old female who developed a recurrent submental cystic mass after being received treatment to remove a certain volume of light-yellow fluid. Pathology verified that mass in the submental area involved by PTMC. We consider that it may relate to age, multifocality, the diameter of PTMC, numbers of central compartment LNs, and "re-metastasis".Gender-affirming procedures are critical steps in helping transgender patients reach identity actualization and maximal quality of life. Although there are many techniques for gender-affirming care, surgical breast augmentation, or "top surgery," is often cited as the most important-and sometimes only-procedure sought by transfeminine patients. Unfortunately, years of individual and systemic prejudice placed barriers between transgender patients and the healthcare providers needed to affirm gender identity. Policy has recently begun to change as research proving the safety, need, and outcomes of breast augmentation in transfeminine patients dismantles long-established systemic inequalities. With this change, more patients are seeking knowledgeable and respectful providers who can address their unique gender-affirming needs. Overall, breast augmentation in transfeminine patients is technically similar to procedures performed in cisgender peers, but with significant considerations. The most common method of augmentation relies on breast implants, since removable prostheses, exogenous hormones, and fat grafting alone often produce unsatisfactory results.