Bilateral Axillo-breast Approach Robotic Thyroid Surgery

Abstract

Remote access thyroidectomy was initially designed to reduce surgical morbidity and avoid neck scars associated with conventional open thyroid surgery. The bilateral axillo-breast approach (BABA) has become one of the most widely used remote access thyroidectomy techniques worldwide. Since first introduced in 2008, BABA robotic thyroid surgery has undergone advances in surgical techniques and systems, with BABA robotic thyroidectomy (BABA RT) resulting in oncological and surgical outcomes similar to those of conventional open thyroidectomy. Also, BABA RT has been shown to be a feasible and safe method, with excellent surgical and oncological results in comparative study with BABA endoscopic thyroidectomy. Indications for BABA RT have been extended to patients with Graves' disease and lymph node metastasis to the lateral neck compartment. Advances in surgical technology have led to novel feasible and safe techniques enabling the identification of important structures during thyroid surgery, including the parathyroid glands and recurrent laryngeal and external branches of the superior laryngeal nerve. International training programs to share knowledge about and techniques of oncoplastic thyroid surgery have been developed to educate surgeons. Future developments in minimally invasive surgery and robotic surgical systems will lead to a greater use of BABA robotic thyroid surgery for patients with thyroid tumors.