Initial Experience of BABA Robotic Thyroidectomy Using the Da Vinci Xi System in Incheon, Korea

Yoon, Hye Jeong; Ahn, Jong-Hyuk; Kim, Jae Hwan; Hur, Min

doi:10.16956/jes.2019.19.3.59

Cited by 8 publications

(12 citation statements)

References 25 publications

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“…The flexible energy device enables safe dissection around all lateral neck node levels. As a result, the number of LNs retrieved in all LN areas did not differ significantly between the two groups [13,17]. The number of retrieved LNs in our study was smaller than in previous studies, which may have resulted from differences between pathologists.…”

Section: Discussioncontrasting

confidence: 77%

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Initial Experience With Robotic Modified Radical Neck Dissection Using the da Vinci Xi System Through the Bilateral Axillo-Breast Approach

Choi

Hong

2021

Clin Exp Otorhinolaryngol

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Objectives: The bilateral axillo-breast approach (BABA) to robotic thyroidectomy has been extended to modified radical neck dissection (MRND). This study assessed outcomes in patients who underwent robotic MRND through BABA using the da Vinci Xi system. Methods: The medical records of 40 patients who underwent total thyroidectomy, bilateral central neck dissection and MRND from September 2018 to March 2020 were reviewed retrospectively, including 12 who underwent robotic surgery and 28 who underwent open surgery. All operations were performed by a single endocrine surgeon. Results: Operation time was significantly longer in the robotic than in the open group (277.08

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Section: Discussioncontrasting

confidence: 77%

“…After robot docking, thyroidectomy procedures were performed as described [ 13 ]. During the MRND phase, the internal jugular vein was exposed by dissection between the strap muscle and the SCM muscle, with the lateral side of the internal jugular vein exposed by cutting the omohyoid muscle ( Fig.…”

Section: Methodsmentioning

confidence: 99%

Initial Experience With Robotic Modified Radical Neck Dissection Using the da Vinci Xi System Through the Bilateral Axillo-Breast Approach

Choi

Hong

2021

Clin Exp Otorhinolaryngol

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“…[22] Thus, we can reduce the breast and axillary scar size and expand our surgery to MRND cases, as we reported elsewhere. [9,18] Although the patients were older, the proportion of males was higher, the tumor size was larger, and the BMI was higher in our analysis, the surgical indication for BABA RT in our hospital was not different from that for OT. Contraindications of BABA RT in our hospital are direct invasion of adjacent organs by the main tumor or metastatic nodes (trachea, vertebra, carotid artery, jugular vein, etc.…”

Section: Discussionmentioning

confidence: 59%

“…Robotic BABA thyroidectomy procedure Robotic BABA thyroid surgery was performed based on the method that we previously reported elsewhere. [18] Thyroid resection was performed in the following order: isthmus division, lateral mobilization with middle thyroid vein ligation, RLN and parathyroid identification, inferior thyroid vessel ligation, berry ligament division and superior pole dissection. In the case of robot BABA thyroidectomy with MRND, we also followed the same method as previously described elsewhere.…”

Section: Open Thyroidectomy Proceduresmentioning

confidence: 99%

“…[12,[15][16][17] Our hospital adopted the da-Vinci Xi system in December 2018 and began performing robotic BABA thyroid surgery with a single endocrine surgeon. [18] As of March 2020, more than 500 cases of robotic BABA thyroid surgery were performed in our institution, and this is the highest number of robotic thyroid surgeries in the city of Inchon in Korea. In this study, we compared our results of robotic BABA thyroid surgery with the OT results and evaluated the advantages and disadvantages of RT compared to OT.…”

Section: Introductionmentioning

confidence: 99%

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Single Surgeon Experience of 500 Cases with the Robotic Bilateral Axillary Breast Approach (BABA) for Thyroid Surgery using the da-Vinci Xi System

Choi¹,

Shin²,

Yi³

2021

Preprint

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Objectives: Robotic bilateral axillary breast approach (BABA) thyroid surgery began in 2008 and is now one of the most widely used remote-access thyroid surgeries worldwide. This study aimed to analyze the results of 500 robotic BABA thyroid surgeries performed in a single institution in Korea compared with open thyroid surgery. Methods: From December 2018 to March 2020, 502 robotic BABA thyroidectomies (RTs) and 531 conventional open thyroidectomies (OTs) were performed in our institution by a single endocrine surgeon. We retrospectively reviewed patient medical records and performed a comparative analysis of OT and RT. Results: The RT group was younger (43.41±11.41 versus 54.28±13.41 years, p<0.001) and had a higher proportion of females (84.3% versus 69.3%, p<0.001), a lower BMI (24.66±3.97 versus 25.83±4.07 kg/m2), a higher proportion of lobectomies (52.6% versus 45.2%) and a lower proportion of lateral neck dissections (3.4% versus 10.0%, p<0.001). The RT group had a lnger operation time (145.33±40.80 versus 93.39±43.55 minutes, p<0.001) and higher surgical cost. Although the OT group had a larger tumor size and higher proportion of extrathyroidal extension, the numbers of retrieved lymph nodes were not significantly different between the two groups. Additionally, there was no difference in the stimulated thyroglobulin level before radioactive iodine therapy (7.01±35.73 versus 8.39±58.77, p=0.782). The rates of transient vocal cord palsy and transient hypoparathyroidism were significantly lower in the RT group, and those of scar-related complications were higher in the OT group. Conclusion: Robotic BABA thyroid surgery has advantages not only in better cosmetic outcomes but also in lower rates of vocal cord palsy and hypoparathyroidism, with comparable lymph node retrieval and serum thyroglobulin levels.

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Harmonic versus LigaSure for Flap Creation in Bilateral Axillary Breast Approach Thyroid Surgery

et al. 2020

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The bilateral axillary breast approach (BABA) is frequently utilized for remote access thyroid surgery. The first step in this surgical approach is to make a subcutaneous flap from the axilla to the neck, usually using a Harmonic ACE. Our institution has utilized LigaSure to create these flaps. This study reports comparative results with these 2 energy devices. Methods: Medical data and video clips from 73 patients who underwent robotic BABA thyroid surgery were retrospectively reviewed. Flaps for BABA were created by first and second year endocrine fellows under the guidance of an experienced endocrine surgeon. There were no criteria for allocation to energy devices. Results: Of the 73 patients, 31 and 42 underwent flap creation with the Harmonic ACE and LigaSure devices, respectively. Demographic characteristics were similar in the 2 groups. Mean time for flap creation was significantly shorter (33.46±8.33 vs. 38.27±7.14 min, P=0.012), and mean number of camera cleanings significantly lower (4.21±2.53 vs. 10.45±4.95, P<0.001), in the LigaSure group. Surgical site pain on day 2 was significantly lower in the LigaSure group. Postoperative bleeding and skin burn occurred only in patients in the Harmonic group. Conclusion: LigaSure showed better performance than the Harmonic ACE device for BABA flap creation, as shown by time for flap creation, postoperative pain scores, and complications. Because this study was a small sized retrospective comparison, large randomized controlled trials are needed to confirm these results.

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Initial Experience of BABA Robotic Thyroidectomy Using the Da Vinci Xi System in Incheon, Korea

Cited by 8 publications

References 25 publications

Initial Experience With Robotic Modified Radical Neck Dissection Using the da Vinci Xi System Through the Bilateral Axillo-Breast Approach

Initial Experience With Robotic Modified Radical Neck Dissection Using the da Vinci Xi System Through the Bilateral Axillo-Breast Approach

Single Surgeon Experience of 500 Cases with the Robotic Bilateral Axillary Breast Approach (BABA) for Thyroid Surgery using the da-Vinci Xi System

Harmonic versus LigaSure for Flap Creation in Bilateral Axillary Breast Approach Thyroid Surgery

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