Robotic Completion Thyroidectomy via the Bilateral Axillo-Breast Approach

Area of Science:

• Endocrine Surgery
• Robotic Surgery
• Thyroid Cancer Treatment

Background:

• Bilateral axillo-breast approach (BABA) robotic thyroidectomy offers excellent cosmetic outcomes for thyroid cancer.
• Completion thyroidectomy after lobectomy may have increased complications due to adhesions, a point of controversy.

Purpose of the Study:

• To evaluate surgical outcomes of BABA robotic completion thyroidectomy.
• To assess operation time and postoperative complications in patients undergoing this procedure.

Main Methods:

• Retrospective review of 33 patients undergoing BABA robotic completion thyroidectomy from Jan 2012 to Aug 2020.
• Procedures analyzed in five distinct surgical steps.
• Clinicopathological data, operation time, and complications were recorded.

Main Results:

• Total operation time for completion thyroidectomy was significantly shorter than the initial operation (164.8 vs. 179.8 min, p=0.043).
• The thyroidectomy step itself was also shorter in completion procedures (69.6 vs. 83.0 min, p=0.009).
• Low complication rates observed: 3.0% hematoma, 9.1% transient hypoparathyroidism, 3.0% permanent hypoparathyroidism, and 6.1% transient vocal cord palsy. No open conversions or major injuries occurred.

Conclusions:

• BABA robotic completion thyroidectomy is a safe procedure.
• The study found no significant completion-related complications.