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Transcervical and robotic-assisted thoracoscopic resection of a substernal goiter
  1. Neha Wadhavkar1,
  2. Ioannis Kontopidis2 and
  3. Craig Bollig1
  1. 1Department of Otolaryngology-Head and Neck Surgery, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA
  2. 2Department of Surgery, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA
  1. Correspondence to Dr Neha Wadhavkar; nmw76{at}


Several genetic and environmental factors contribute to the development of multinodular goitre. A transcervical surgical resection is recommended for larger goitres, though a minority of cases may require sternotomy or thoracotomy. We present a case of a posterior substernal goitre that was resected with combined transcervical and robotically assisted thoracic approaches. A woman in her 30s with an enlarging thyroid goitre elected to proceed with surgical resection. CT imaging demonstrated significant extension of the goitre into the posterior mediastinum and a staged approach was decided on. Both the initial transcervical thyroidectomy and the subsequent robotically assisted resection of the mediastinal portion were successful, without major complications. While most substernal goitres can be resected transcervically, certain rare anatomic features, such as extension into the posterior mediastinum, warrant consideration of a thoracic approach. Specifically, a robotic-assisted resection poses several advantages over traditional, more invasive approaches.

  • Ear, nose and throat/otolaryngology
  • Thyroid disease
  • Head and neck surgery

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  • Contributors NW: writing of original draft, editing and reviewing. IK: editing and reviewing. CB: conceptualisation and design, writing of original draft, editing, reviewing and supervision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.