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Updated: May 9, 2026

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
05:10

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Published on: September 15, 2023

[Robot-assisted transaxillary thyroid surgery].

Menno R Vriens1, Jakob W Kist, Lutske Lodewijk

  • 1Universitair Medisch Centrum Utrecht, afd. Heelkunde, Utrecht, the Netherlands. m.r.vriens@umcutrecht.nl

Nederlands Tijdschrift Voor Geneeskunde
|July 12, 2013
PubMed
Summary
This summary is machine-generated.

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Robot-assisted transaxillary thyroidectomy (RATT) offers a scarless approach for benign thyroid nodules up to 3cm. This new technique requires thorough preparation and a proctoring program for successful implementation.

Area of Science:

  • Minimally Invasive Surgery
  • Surgical Robotics
  • Endocrinology

Background:

  • Robot-assisted transaxillary thyroidectomy (RATT) is a novel surgical technique.
  • This method utilizes the da Vinci S surgical robot for thyroid gland access via an axillary approach.
  • The procedure has been recently introduced in the Netherlands.

Purpose of the Study:

  • To describe the technique of robot-assisted transaxillary thyroidectomy.
  • To outline the indications and learning curve for RATT.
  • To highlight the advantages and disadvantages of RATT compared to conventional thyroidectomy.

Main Methods:

  • A subcutaneous tunnel is created from the axilla to access the thyroid gland.
  • The surgery is performed using the da Vinci S robot, mimicking an open procedure.

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  • Initial cases focus on hemithyroidectomies for nodules up to 3cm, preferably benign.

    • Main Results:

    • RATT allows for thyroidectomy without a neck scar, a significant cosmetic advantage.
    • The technique is suitable for total thyroidectomy, though hemithyroidectomy is recommended for initial learning.
    • High costs compared to conventional procedures represent a major disadvantage.

    Conclusions:

    • Successful introduction of RATT necessitates comprehensive preparation for surgical teams and personnel.
    • A structured proctoring program is essential for mastering the RATT technique.
    • RATT presents a viable, albeit costly, alternative for thyroidectomy, prioritizing aesthetic outcomes.