Endoscopic thyroidectomy via bilateral axillo-breast approach (BABA): review of 512 cases in a single institute

Choi, June Young; Lee, Kyu Eun; Chung, Ki-Wook; Kim, Seok-Won; Choe, Jun-Ho; Koo, Do Hoon; Kim, Sujin; Lee, Jeonghun; Chung, Yoo Seung; Oh, Seung Keun; Youn, Yeo-Kyu

doi:10.1007/s00464-011-1973-x

Cited by 121 publications

(106 citation statements)

References 19 publications

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“…However, small scars remain on the anterior region of the neck via video-assisted thyroidectomy (16), on the chest wall and nipples for the breast approach, and on the axilla via bilateral transaxillary approach (25) as well as the BABA (7,26,27). Interestingly, the average pain scores from the first to third operative day were lower in TOETVA patients than in OT patients (2.72±0.94 vs. 1.08±1.01, P<0.05).…”

Section: Discussionmentioning

confidence: 99%

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) for Graves’ disease: a comparison of surgical results with open thyroidectomy

et al. 2016

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Background: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) provides excellent cosmetic results from its potential for scar-free operation. The procedure has been applied successfully for Graves' disease by the authors of this work and compared with the standard open cervical approach to evaluate its safety and outcomes.Methods: From January 2014 to November 2016, a total of 97 patients with Graves' disease were reviewed retrospectively. Open thyroidectomy (OT) and TOETVA were performed in 49 patients and 46 patients, respectively. For TOETVA, a three-port technique through the oral vestibule was utilized. The thyroidectomy was done endoscopically using conventional laparoscopic instruments and an ultrasonic device. Patient demographics and surgical variables, including operative time, blood loss, and complications, were investigated and compared.Results: TOETVA was performed successfully in all 45 patients, although conversion to open surgery was deemed necessary in one patient. All patient characteristics for both groups were similar. Operative time was shorter for the OT group compared to the TOETVA group, which totaled 101.97±24.618 and 134.11±31.48 minutes, respectively (P<<0.5). Blood loss was comparable for both groups. The visual analog scale (VAS) pain score for the TOETVA group was significantly lower than for the OT group on day 1 (2.08±1.53 vs. 4.57±1.35), day 2 (0.84±1.12 vs. 2.57±1.08) and day 3 (0.33±0.71 vs. 1.08±1.01) (P<<0.05).Transient recurrent laryngeal nerve (RLN) palsy was found in four and two cases of TOETVA and OT group, respectively. Transient hypocalcemia was found in ten and seven cases of TOETVA and OT group, respectively. No other complications were observed.Conclusions: TOETVA is a feasible and safe treatment for Graves' disease in comparison to the standard open cervical approach. It is considered a viable alternative for patients who have been indicated for surgery with excellent cosmetic results.

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Section: Discussionmentioning

confidence: 99%

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) for Graves’ disease: a comparison of surgical results with open thyroidectomy

et al. 2016

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“…Due to the limitations of narrow working space, two-dimensional operative view and restricted instrument manipulation, BABA endoscopic procedures could be applied to a small subset of patients only (5,6). With the advent of the Da Vinci robotic system (Intuitive Surgical, Inc., Sunnyvale, CA, USA), many technical disadvantages of BABA ET could be substantially overcome and the indications of BABA robotic thyroidectomy (RT) could be largely extended (7).…”

Section: Review Articlementioning

confidence: 99%

Bilateral axillo-breast approach robotic thyroidectomy: review of evidences

Liu

Kim

2017

Gland Surg.

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Abstract:The bilateral axillo-breast approach (BABA) is one of the most popular contemporary remoteaccess thyroidectomy techniques. While the initial experiences with BABA endoscopic thyroidectomy (ET)were associated with some technical challenges and safety concerns, many limitations of the technique could now be substantially overcome by BABA robotic thyroidectomy (RT). In this review, the current literature evidences of BABA RT were analyzed. Data regarding the patient selection, the learning curve, and the comparison with open thyroidectomy (OT) and BABA ET were examined. Careful case selection for BABA RT should be undertaken according to factors related to the patient and the thyroid pathology.The learning curve of BABA RT was about 40 cases. Comparing to OT, BABA RT was comparable to OT for the complication profiles and most perioperative outcomes. But it was associated with longer operative time, higher cost and possibly inferior oncological control with lower number of central lymph node (LN) retrieved. When compared to BABA ET, BABA RT was comparable for most perioperative outcomes except longer operative time and higher cost. Yet, BABA RT was superior to BABA ET for better oncological control. BABA RT is a safe and effective procedure for most benign thyroid conditions and low-risk differentiated thyroid cancers (DTC).

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“…However, ETBA is inferior in terms of cosmetics as it may leave a hypertrophic parasternal scar (21,23). To resolve this issue, the breast and axillary approaches were combined, including the bilateral axillo-breast approach (BABA) (24), axillo-bilateral breast approach (ABBA) (25) and bilateral breast areola and ipsilateral ETBA with the mini-instrument results in a scar with an almost identical appearance since the 2-mm miniincision was no longer evident during the follow-up 3 months postoperatively. The NSS score did not differ significantly for patients who underwent the ETBA-m and those who underwent the sETBA, but all of the patients who underwent ETBA-m felt that endoscopic thyroidectomy with a mini-instrument yielded a better cosmetic appearance after viewing a picture of the scars of a patient who underwent sETBA.…”

Section: Discussionmentioning

confidence: 99%

Use of a mini-instrument in endoscopic thyroidectomy via a breast approach to improve cosmetic outcomes

Zhang

Dang

Shan

et al. 2014

BST

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Endoscopic thyroidectomy via bilateral axillo-breast approach (BABA): review of 512 cases in a single institute

Cited by 121 publications

References 19 publications

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) for Graves’ disease: a comparison of surgical results with open thyroidectomy

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) for Graves’ disease: a comparison of surgical results with open thyroidectomy

Bilateral axillo-breast approach robotic thyroidectomy: review of evidences

Use of a mini-instrument in endoscopic thyroidectomy via a breast approach to improve cosmetic outcomes

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