What Are the Most Effective Strategies for Recurrent Laryngeal Nerve Preservation in Robotic Thyroidectomy for Advanced Thyroid Cancer?: A Comprehensive Review

The recurrent laryngeal nerve (RLN) plays a critical role in maintaining vocal function, and its preservation during thyroid cancer surgery is essential for optimal patient outcomes. This review examines current techniques for RLN preservation, including intraoperative nerve monitoring, sharp dissection, and nerve reconstruction. Additionally, it explores the role of robot-assisted thyroidectomy, particularly the bilateral axillo-breast approach, in enhancing RLN preservation. Advancements in surgical technology and techniques are discussed, along with their implications for future practice. By synthesizing existing evidence, this review aims to guide surgeons in achieving both oncological safety and functional preservation.