Analysis of Initial Experience of Robotic Bilateral Axillo-Breast Approach Thyroidectomy For 30 Months

Abstract

Purpose: Robotic bilateral axillo-breast approach (BABA) thyroidectomy has been performed over 10 years in Korea. Compared with conventional open thyroidectomy, BABA has been shown to be not inferior when implemented in selected cases, and it has been associated with favorable cosmetic outcomes. This study aimed to evaluate our initial experiences with robotic BABA thyroidectomy (starting in 2020) and to share our lessons and perspectives with other surgeons. Methods: We retrospectively reviewed 237 cases of robotic BABA thyroidectomy between January 2020 and June 2022 at Gachon University Gil Medical Center in Incheon, Korea. The operations were divided into 3 equal-sized groups according to chronological sequence. Results: Mean age of the patients was 45.4 years and female patients was 82.7%. The mean body mass index was 24.54±3.63 kg/m2 . The mean tumor size was 1.33±1.20 cm (range, 0.3–5.7). Total thyroidectomy was performed in 63 cases and completion thyroidectomy was 4 cases. The mean of operation time was 203.56±51.42 minutes and console time was 123.72±46.40 minutes. Malignancy cases were 83.7% and papillary thyroid carcinoma was 93.4% in malignancy. The mean tumor size was 1.07±0.93 cm (range, 0.3–5.7) in malignant cases. According to intervals of surgery along proceeding operation, operation time and console time decreased (P=0.001 and P<0.001, respectively). Postoperative complication such as hypocalcemia and recurrent laryngeal nerve palsy did not show statistically significant difference in three intervals. Conclusion: Robotic BABA thyroidectomy can be applied in the treatment of both benign and malignant thyroid disease, and completion robotic BABA thyroidectomy can also be performed safely