Robotic lateral cervical lymph node dissection via bilateral axillo-breast approach for papillary thyroid carcinoma: a single-center experience of 260 cases

Qingqing He,Xiaolei Li,Gang Wang,Peng Zhou,Meng Wang,Dandan Li,Jian Zhu,Fang Yu,Xuefeng Dong,Luming Zheng,Lei Hou,Ziyi Fan,Gaofeng Ni,Dan Wang,Mengdi Wang,Changrui Liu,Dayong Zhuang,Tao Yue

doi:10.1007/s11701-019-00986-3

Abstract

To evaluate the feasibility and safety of robotic lateral cervical lymph node dissection via BABA, 260 thyroid cancer patients with suspected level II, III, IV, and Vb lymph node metastasis were selected. The lateral cervical compartment was exposed by splitting the sternocleidomastoid muscle longitudinally, and separating between the strap muscles and the anterior margin of the sternocleidomastoid muscle. The procedure was completed in 260 patients. Mean time for robotic lateral node dissection took 80 ± 21 min. The wound catheter was removed 6.3 days. Postoperative transient symptomatic hypocalcemia was observed in 51 patients, transient hoarseness in three, seroma in three, chyle leakage in two, and tracheal injury in one. 124 patients were confirmed to have lymph node metastasis on final pathological report. Average postoperative hospital stay was 6.5 days. Robotic lateral neck dissection by BABA is the acceptable operative alternative for thyroid cancer patients who wished to keep their surgical history private.

Highlights

IntroductionCrile who was the first to describe radical neck dissection in 1906
Recent innovation in the surgical technique of thyroidectomy has offered the opportunity for the patients to stay away from these prominent neck incision scars
With the advent of robotic surgical system (Intuitive Surgical, Sunnyvale, CA), many have adopted the concept of remote-access surgery and developed various robotic thyroidectomy techniques [1,2,3]

Summary

Introduction

Crile who was the first to describe radical neck dissection in 1906. Recent innovation in the surgical technique of thyroidectomy has offered the opportunity for the patients to stay away from these prominent neck incision scars. With the advent of robotic surgical system (Intuitive Surgical, Sunnyvale, CA), many have adopted the concept of remote-access surgery and developed various robotic thyroidectomy techniques [1,2,3]. In China, bilateral axillo-breast approach (BABA) was utilized in most cases of robotic total thyroidectomy. BABA robotic thyroidectomy makes four tiny incisions (5–12 mm) at areolae and skin creases of the axillae, and can perform

Methods

Results

Conclusion