Feasibility of Doing a Safe Robotic Thyroidectomy in a Developing Country and Comparison of 2 Different Techniques

This study aims to present our experience with robotic thyroidectomy approaches for differentiated thyroid carcinoma (DTC) vis a vis Modified BABA (Bilateral Axillo Breast Approach) and Retroauricular approach. Retrospective observational single institution-based study comprising 19 patients who underwent robotic thyroid surgery for DTC between October 2018 and January 2022. All patients underwent robotic thyroidectomy using the da Vinci Xi Robotic surgical system. Nineteen patients underwent robotic thyroidectomy with none needing conversion to open surgery. The Modified BABA approach was used for 9 patients (47%), whereas the Retroauricular approach (RA) was used for 10 patients (53%). In the RA group, 6 patients (60%) underwent total thyroidectomy and 4 patients (40%) underwent hemithyroidectomy. The Modified BABA approach was used for total thyroidectomy in 8 (89%) patients whereas 1 patient (11%) underwent hemithyroidectomy utilizing this approach. In 10 patients, central compartment clearance was done (5 through Modified BABA and 5 through RA). Lateral neck nodes were addressed in 4 patients (1 through Modified BABA and 3via RA). The median hospital stay was 4 days (range: 2-6 days). None of the 19 patients had post-operative complications like RLN palsy or any scar-related complaints /hypertrophic scars. The average PTH value post-op was 32.1 pg/ml (range: 3.8-70.4 pg/ml). Based on the current evidence from the literature, robotic thyroidectomy for thyroid carcinoma stands out from conventional surgery by resulting in sound oncological clearance with a superior cosmetic result by avoiding a scar in the anterior neck.