Bilateral axillo-breast approach (BABA) robotic neck dissection for papillary thyroid carcinomas

Bilateral axillo-breast approach (BABA) robotic neck dissection for papillary thyroid carcinomas

Papillary thyroid carcinoma (PTC), the most commonly diagnosed thyroid malignancy, frequently presents with lymph node metastases. Effective management of metastatic lymph nodes is crucial due to the disease's high recurrence rates. Herein, we present our approach to robotic thyroidectomy and central/lateral neck node dissection, which has shown comparable oncologic outcomes, reduced complications, and improved cosmetic results compared to open surgeries. We detail the surgical procedure, from patient positioning and flap dissection, through central and lateral neck dissection, to closure. The BABA robotic modified radical neck dissection (MRND) is primarily recommended for patients with well-differentiated thyroid carcinoma, predominantly PTC, presenting with suspected or pathologically confirmed lateral neck metastasis. We also discuss the application of the da Vinci robot settings in performing precise procedures and preserving critical anatomical structures. This comprehensive review provides insights into the effectiveness of BABA robotic thyroid surgery and central/lateral neck node dissection in managing PTC.