Reduced Port Robotic Bilateral Axillo-Breast Approach (BABA) Isthmusectomy

Purpose: To investigate whether reduced port robotic bilateral axillo-breast approach (BABA) surgery can be a safe alternative approach for patients undergoing isthmusectomy for well differentiated papillary thyroid cancer confined to the isthmus. Methods: A total of 45 patients with well differentiated papillary thyroid cancer confined to the isthmus underwent reduced port robotic BABA isthmusectomy by a single surgeon from March 1st 2020 to November 30th 2021. The left areolar port was omitted in all cases of surgery. Patients’ records were reviewed to determine surgical adequacy and whether if the surgery was feasible. Results: The average operation time was 71.02 minutes (range, 37-108 minutes; standard deviation [SD], 16.22 minutes). Patients were discharged at an average of 2.15 days after surgery. There were no cases of vocal cord palsy or hypocalcemia. An average of 3.95 (range, 0-11; SD, 2.80) central lymph nodes were obtained per surgery. Conclusion: Reduced port robotic BABA surgery is a feasible and safe alternative option for thyroid isthmusectomy. However, a thorough pre-operative evaluation is needed for selecting adequate patients.