Bilateral Axillo-breast Approach Robotic Thyroid Surgery

Kwak, JungHak; Yu, Hyeong Won; Lee, Kyu Eun

doi:10.37007/aris.2020.1.2.69

Cited by 9 publications

(13 citation statements)

References 43 publications

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“…BABA RT has been performed for more than 10 years, and its surgical indi-cations expanded widely to include large thyroid cancers, minor extrathyroidal extension, neck node dissection including central and lateral neck nodes (MRND), and combined thyroiditis or Graves' disease [9]. Surgical and oncologic safety has also been shown in many previous studies [4,12,17,21,22].…”

Section: Discussionmentioning

confidence: 99%

“…Unlike other endoscopic or robotic thyroidectomy methods, such as the transaxillary or retroauricular approaches, the BABA provides a symmetric, surgical view of both thyroid lobes, which is similar to conventional open thyroidectomy. This enables optimal visualization of important structures such as the parathyroid gland, recurrent and superior laryngeal nerves, and blood vessels [ 21 ]. In the early time period of BABA RT, surgical indications for thyroid cancer were very narrow and included thyroid cancer measuring under 1 cm, no evidence of lymph node metastasis, no evidence of extrathyroidal extension, concurrent thyroiditis or Graves’ disease, and no history of neck radiation, among others [ 10 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…This enables optimal visualization of important structures such as the parathyroid gland, recurrent and superior laryngeal nerves, and blood vessels [ 21 ]. In the early time period of BABA RT, surgical indications for thyroid cancer were very narrow and included thyroid cancer measuring under 1 cm, no evidence of lymph node metastasis, no evidence of extrathyroidal extension, concurrent thyroiditis or Graves’ disease, and no history of neck radiation, among others [ 10 , 21 ]. BABA RT has been performed for more than 10 years, and its surgical indications expanded widely to include large thyroid cancers, minor extrathyroidal extension, neck node dissection including central and lateral neck nodes (MRND), and combined thyroiditis or Graves’ disease [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

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Single Surgeon Experience with 500 Cases of the Robotic Bilateral Axillary Breast Approach (BABA) for Thyroid Surgery Using the Da-Vinci Xi System

Choi

Shin

2021

JCM

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Objectives: Robotic bilateral axillary breast approach (BABA) thyroid surgery began in 2008 and is now one of the most widely used remote-access thyroid surgeries worldwide. This study aimed to analyze the results of 500 robotic BABA thyroid surgeries performed in a single institution in Korea compared with open thyroid surgery. Methods: From December 2018 to March 2020, 502 robotic BABA thyroidectomies (RTs) and 531 conventional open thyroidectomies (OTs) were performed in our institution by a single endocrine surgeon. We retrospectively reviewed patient medical records and performed a comparative analysis of OT and RT. Results: The RT group was younger (43.41 ± 11.41 versus 54.28 ± 13.41 years, p < 0.001) and had a higher proportion of females (84.3% versus 69.3%, p < 0.001), a lower BMI (24.66 ± 3.97 versus 25.83 ± 4.07 kg/m2), a higher proportion of lobectomies (52.6% versus 45.2%) and a lower proportion of lateral neck dissections (3.4% versus 10.0%, p < 0.001). The RT group had a longer operation time (145.33 ± 40.80 versus 93.39 ± 43.55 min, p < 0.001) and higher surgical costs. Although the OT group had a larger tumor size and a higher proportion of extrathyroidal extension, the numbers of retrieved lymph nodes were not significantly different between the two groups. Additionally, there was no difference in the stimulated thyroglobulin level before radioactive iodine therapy (7.01 ± 35.73 versus 8.39 ± 58.77, p = 0.782). The rates of transient vocal cord palsy and transient hypoparathyroidism were significantly lower in the RT group, and those of scar-related complications were higher in the OT group. Conclusions: Robotic BABA thyroid surgery has advantages not only in better cosmetic outcomes but also in lower rates of vocal cord palsy and hypoparathyroidism, with comparable lymph node retrieval and serum thyroglobulin levels.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Single Surgeon Experience with 500 Cases of the Robotic Bilateral Axillary Breast Approach (BABA) for Thyroid Surgery Using the Da-Vinci Xi System

Choi

Shin

2021

JCM

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“…This enables optimal visualization of important structures such as the parathyroid gland, recurrent and superior laryngeal nerves and blood vessels. [20] In the early time period of BABA RT, surgical indications for thyroid cancer were very narrow and included thyroid cancer measuring under 1 cm, no evidence of lymph node metastasis, no evidence of extrathyroidal extension, concurrent thyroiditis or Graves' disease, and no history of neck radiation, among others.…”

Section: Discussionmentioning

confidence: 99%

“…[9] Surgical and oncologic safety has also been shown in many previous studies. [4,12,17,20,21] Beginning on December 24, 2018, BABA RT using the da-Vinci Xi system was started in our hospital. More than 200 cases have been performed per year, and a total of 500 cases have been performed within 3 years by a single endocrine surgeon.…”

Section: Discussionmentioning

confidence: 99%

Single Surgeon Experience of 500 Cases with the Robotic Bilateral Axillary Breast Approach (BABA) for Thyroid Surgery using the da-Vinci Xi System

Choi¹,

Shin²,

Yi³

2021

Preprint

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Objectives: Robotic bilateral axillary breast approach (BABA) thyroid surgery began in 2008 and is now one of the most widely used remote-access thyroid surgeries worldwide. This study aimed to analyze the results of 500 robotic BABA thyroid surgeries performed in a single institution in Korea compared with open thyroid surgery. Methods: From December 2018 to March 2020, 502 robotic BABA thyroidectomies (RTs) and 531 conventional open thyroidectomies (OTs) were performed in our institution by a single endocrine surgeon. We retrospectively reviewed patient medical records and performed a comparative analysis of OT and RT. Results: The RT group was younger (43.41±11.41 versus 54.28±13.41 years, p<0.001) and had a higher proportion of females (84.3% versus 69.3%, p<0.001), a lower BMI (24.66±3.97 versus 25.83±4.07 kg/m2), a higher proportion of lobectomies (52.6% versus 45.2%) and a lower proportion of lateral neck dissections (3.4% versus 10.0%, p<0.001). The RT group had a lnger operation time (145.33±40.80 versus 93.39±43.55 minutes, p<0.001) and higher surgical cost. Although the OT group had a larger tumor size and higher proportion of extrathyroidal extension, the numbers of retrieved lymph nodes were not significantly different between the two groups. Additionally, there was no difference in the stimulated thyroglobulin level before radioactive iodine therapy (7.01±35.73 versus 8.39±58.77, p=0.782). The rates of transient vocal cord palsy and transient hypoparathyroidism were significantly lower in the RT group, and those of scar-related complications were higher in the OT group. Conclusion: Robotic BABA thyroid surgery has advantages not only in better cosmetic outcomes but also in lower rates of vocal cord palsy and hypoparathyroidism, with comparable lymph node retrieval and serum thyroglobulin levels.

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A Time Trend Analysis of 5,000 Robotic Thyroidectomies via Bilateral Axillo‐Breast Approach

Kwak

Ahn

et al. 2022

World j. surg.

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Background This study aimed to investigate the time trends of surgical outcomes in patients who underwent bilateral axillo‐breast approach robotic thyroidectomy (BABA RT) over the last 14 years. Methods From February 2008 to September 2021, we conducted a retrospective medical chart review of 5,011 consecutive patients who underwent BABA RT at three Seoul National University‐affiliated hospitals. The patients were divided into three groups based on the main model of the da Vinci robotic surgical system to evaluate trends in surgical treatment strategies and outcomes after BABA RT. Results Of the 5,011 patients (4,706 malignant and 305 benign), the most common histological subtype was papillary thyroid carcinoma (n = 4,584; 97.4%). The mean tumor size significantly increased from 0.8 cm to 1.2 cm (p < 0.05). The mean numbers of metastatic and harvested lymph nodes from the central neck dissection and the lateral neck dissection showed a significant difference and tendency to increase (from 0.9 to 1.6, 4.7 to 6.2, p < 0.05, and from 0.6 to 3.9, 5.3 to 17.9, p < 0.05), respectively, throughout the study period. Permanent hypoparathyroidism decreased from 3.4 to 2.9%. The rate of transient and permanent vocal cord palsy decreased from 15.2 to 2.7% and from 0.7 to 0.2%, respectively. Conclusion With advancements in robotic surgical systems and improvements in the BABA RT technique, surgical indications have expanded to include more advanced thyroid diseases, and surgical outcomes have improved over the last 14 years.

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Bilateral Axillo-breast Approach Robotic Thyroid Surgery

Cited by 9 publications

References 43 publications

Single Surgeon Experience with 500 Cases of the Robotic Bilateral Axillary Breast Approach (BABA) for Thyroid Surgery Using the Da-Vinci Xi System

Single Surgeon Experience with 500 Cases of the Robotic Bilateral Axillary Breast Approach (BABA) for Thyroid Surgery Using the Da-Vinci Xi System

Single Surgeon Experience of 500 Cases with the Robotic Bilateral Axillary Breast Approach (BABA) for Thyroid Surgery using the da-Vinci Xi System

A Time Trend Analysis of 5,000 Robotic Thyroidectomies via Bilateral Axillo‐Breast Approach

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