Robotic thyroid surgery using bilateral axillo-breast approach: From a trainees' point of view

BACKGROUND: Across surgical disciplines, the demand for cosmetically superior procedures is stronger than ever and patient-centered health care has become the standard of care. Endoscopic thyroidectomy has revolutionized the field of minimal access endocrine surgery and akin to other surgical disciplines, there has been a natural progression towards robot-assisted thyroidectomy. Amongst the many described approaches, bilateral axillo-breast approach (BABA) and transaxillary are most widely practiced. AIMS AND OBJECTIVES: Our aim was to describe the technique of robot-assisted thyroid surgery (RATS) using BABA. METHODS: This is based on the corresponding authors' training and experience of over 50 cases of RATS using BABA, at the Seoul National University, Republic of Korea. RESULTS: Post-operative outcomes were excellent with lesser pain, better cosmesis and similar oncological outcomes in carefully selected thyroid cancers in comparison to conventional thyroidectomy. CONCLUSION: RATS using BABA is easy to master for endoscopic thyroid surgeons and offers excellent postoperative outcomes, ergonomics, vision and dexterity.