Skip to main content

Advertisement

Log in

Robotic-assisted modified radical neck dissection using a bilateral axillo-breast approach (robotic BABA MRND) for papillary thyroid carcinoma with lateral lymph node metastasis

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Although safe in patients with papillary thyroid carcinoma (PTC), robotic thyroidectomy using a bilateral axillo-breast approach (BABA) has not been frequently performed in patients with advanced PTC. This study describes surgical outcomes in patients with PTC and lymph node metastasis (LNM) in lateral neck compartment who underwent robotic-assisted modified radical neck dissection with BABA (robotic BABA MRND).

Methods

The medical records of patients with PTC and lateral LNM who underwent robotic BABA MRND from March 2010 to July 2016 were retrospectively reviewed.

Results

Fifteen patients, 14 women and 1 man, of mean age 37.1 ± 9.3 years, were enrolled. Mean operation time was 272.7 ± 33.8 min. A mean 20.7 ± 7.2 lymph nodes were retrieved from the lateral neck compartment, with a mean 5.3 ± 4.4 lymph nodes being metastatic. The rates of transient and permanent hypocalcemia were 46.7 and 0%, respectively, and the rates of transient and permanent vocal cord palsy were 6.7 and 0%, respectively. Fourteen patients (93.3%) had stimulated thyroglobulin concentrations below 2 ng/mL after the first treatment with radioactive iodine.

Conclusions

Robotic BABA MRND could be safely performed and may be a good surgical option in selected patients with PTC and lateral LNM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Lang BH-H, Wong CKH, Tsang JS, Wong KP, Wan KY (2014) A systematic review and meta-analysis comparing surgically-related complications between robotic-assisted thyroidectomy and conventional open thyroidectomy. Ann Surg Oncol 21:850–861. doi: 10.1245/s10434-013-3406-7

    Article  PubMed  Google Scholar 

  2. Lee KE, Koo DH, Kim SJ, Lee J, Park KS, Oh SK, Youn YK (2010) Outcomes of 109 patients with papillary thyroid carcinoma who underwent robotic total thyroidectomy with central node dissection via the bilateral axillo-breast approach. Surgery 148:1207–1213. doi: 10.1016/j.surg.2010.09.018

    Article  PubMed  Google Scholar 

  3. Lee KE, Kim E, Koo DH, Choi JY, Kim KH, Youn YK (2013) Robotic thyroidectomy by bilateral axillo-breast approach: review of 1026 cases and surgical completeness. Surg Endosc 27:2955–2962. doi: 10.1007/s00464-013-2863-1

    Article  PubMed  Google Scholar 

  4. Lee KE, Choi JY, Youn Y-K (2011) Bilateral axillo-breast approach robotic thyroidectomy. Surg Laparosc Endosc Percutan Tech 21:230–236. doi: 10.1097/SLE.0b013e31822d0455

    Article  PubMed  Google Scholar 

  5. Choi JY, Lee KE, Chung KW, Kim SW, Choe JH, Koo DH, Kim SJ, Lee J, Chung YS, Oh SK, Youn YK (2012) Endoscopic thyroidectomy via bilateral axillo-breast approach (BABA): review of 512 cases in a single institute. Surg Endosc Other Interv Tech 26:948–955. doi: 10.1007/s00464-011-1973-x

    Article  Google Scholar 

  6. Lee KE, Koo DH, Im HJ, Park SK, Choi JY, Paeng JC, Chung JK, Oh SK, Youn YK (2011) Surgical completeness of bilateral axillo-breast approach robotic thyroidectomy: comparison with conventional open thyroidectomy after propensity score matching. Surgery 150:1266–1274. doi: 10.1016/j.surg.2011.09.015

    Article  PubMed  Google Scholar 

  7. Chai YJ, Suh H, Woo J-W, Yu HW, Song R-Y, Kwon H, Lee KE (2016) Surgical safety and oncological completeness of robotic thyroidectomy for thyroid carcinoma larger than 2 cm. Surg Endosc. doi: 10.1007/s00464-016-5097-1

    Google Scholar 

  8. Kang SW, Lee SH, Ryu HR, Lee KY, Jeong JJ, Nam KH, Chung WY, Park CS (2010) Initial experience with robot-assisted modified radical neck dissection for the management of thyroid carcinoma with lateral neck node metastasis. Surgery 148:1214–1221. doi: 10.1016/j.surg.2010.09.016

    Article  PubMed  Google Scholar 

  9. Lee J, Kwon IS, Bae EH, Chung WY (2013) Comparative analysis of oncological outcomes and quality of life after robotic versus conventional open thyroidectomy with modified radical neck dissection in patients with papillary thyroid carcinoma and lateral neck node metastases. J Clin Endocrinol Metab 98:2701–2708. doi: 10.1210/jc.2013-1583

    Article  CAS  PubMed  Google Scholar 

  10. Seup Kim B, Kang KH, Park SJ (2015) Robotic modified radical neck dissection by bilateral axillary breast approach for papillary thyroid carcinoma with lateral neck metastasis. Head & Neck 37(1):37–45

    Article  Google Scholar 

  11. Kim S, Eun Lee K, Pyo Myong J, Ra Kwon M, Youn Y-K (2011) Recovery of sensation in the anterior chest area after bilateral axillo-breast approach endoscopic/robotic thyroidectomy. Surg Laparosc Endosc Percutan Tech 21:366–371. doi: 10.1097/SLE.0b013e31822dd24f

    Article  PubMed  Google Scholar 

  12. Luster M, Clarke SE, Dietlein M, Lassmann M, Lind P, Oyen WJG, Tennvall J, Bombardieri E (2008) Guidelines for radioiodine therapy of differentiated thyroid cancer. Eur J Nucl Med Mol Imaging 35:1941–1959. doi: 10.1007/s00259-008-0883-1

    Article  CAS  PubMed  Google Scholar 

  13. Bae DS, Suh BJ, Park JK, Koo DH (2016) Technical, oncological, and functional safety of bilateral axillo-breast approach (BABA) robotic total thyroidectomy. Surg Laparosc EndoSc Percutan Tech 26:253–258

    Article  PubMed  Google Scholar 

  14. Lee S (2015) Robotic thyroidectomy : pros and cons of various surgical approaches. Korean J Endocr Surg 1703:73–78

    Article  Google Scholar 

  15. Lee KE, Rao J, Youn Y-K (2009) Endoscopic thyroidectomy with the da Vinci robot system using the bilateral axillary breast approach (BABA) technique: our initial experience. Surg Laparosc Endosc Percutan Tech 19:e71–e75. doi: 10.1097/SLE.0b013e3181a4ccae

    Article  PubMed  Google Scholar 

  16. Chai YJ, Lee KE, Youn Y (2014) Can robotic thyroidectomy be performed safely in thyroid carcinoma patients ? Endocrinol Metab 29:226–232. doi: 10.3803/EnM.2014.29.3.226

    Article  Google Scholar 

  17. Reeve T, Thompson NW (2000) Complications of thyroid surgery: how to avoid them, how to manage them, and observations on their possible effect on the whole patient. World J Surg 24:971–975. doi: 10.1007/s002680010160

    Article  CAS  PubMed  Google Scholar 

  18. Landry CS, Grubbs EG, Stephen Morris G, Turner NS, Christopher Holsinger F, Lee JE, Perrier ND (2011) Robot assisted transaxillary surgery (RATS) for the removal of thyroid and parathyroid glands. Surgery 149:549–555. doi: 10.1016/j.surg.2010.08.014

    Article  PubMed  Google Scholar 

  19. Konia MR, Reiner M, Apostolido I (2013) Acute persistent brachial plexopathy after robot-assisted transaxillary right thyroid lobe resection. J Clin Anesth 25:166–169. doi: 10.1016/S0924-977X(10)70869-5

    Article  PubMed  Google Scholar 

  20. Kang SW, Lee SC, Lee SH, Lee KY, Jeong JJ, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: the operative outcomes of 338 consecutive patients. Surgery 146:1048–1055. doi: 10.1016/j.surg.2009.09.007

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Science, ICT & Future Planning, Republic of Korea (Grant Number: 2015R1C1A1A01055464).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kyu Eun Lee.

Ethics declarations

Disclosures

Hyeong Won Yu, Young Jun Chai, Su-jin Kim, June Young Choi, and Kyu Eun Lee have no conflicts of interest or financial ties to disclose.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (WMV 217077 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yu, H.W., Chai, Y.J., Kim, Sj. et al. Robotic-assisted modified radical neck dissection using a bilateral axillo-breast approach (robotic BABA MRND) for papillary thyroid carcinoma with lateral lymph node metastasis. Surg Endosc 32, 2322–2327 (2018). https://doi.org/10.1007/s00464-017-5927-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-017-5927-9

Keywords

Navigation