Robotic Thyroidectomy for Thyroid Cancer: Experience from Fujian,China

Abstract

Introduction:

Robotic thyroidectomy has emerged as an advanced technique in thyroid cancer surgery, offering significant advantages over conventional approaches. The da Vinci robotic system provides superior visualization and dexterity, offering greater control in confined spaces. This video presents the experience of robotic thyroidectomy for thyroid cancer via the Bilateral Axillo-Breast Approach (BABA), highlighting its technical advantages, functional preservation, and innovative technologies.

Methods:

This video demonstrates robotic thyroidectomy using the BABA approach, which allows for precise dissection in fascial layers, ensuring safe and effective nerve and parathyroid gland preservation. The synchronized eye-hand coordination between the surgeon and robotic instruments, coupled with tremor filtering, enhances surgical precision and minimizes the risk of inadvertent injury to vital structures. Intraoperative neuromonitoring (IONM) is used to protect the recurrent laryngeal nerve and external branch of the superior laryngeal nerve. ¹ In addition, the video showcases the use of artificial intelligence in the preservation of the parathyroid glands, with the PTAIR (Artificial Intelligence model for Parathyroid gland Recognition) deep learning model significantly improving parathyroid identification and ischemia detection. ² The application of carbon nanoparticle tracers for lymph node identification also aids in the precise removal of lymph nodes, further enhancing the oncological effectiveness of the procedure. ³

Results:

Since the initiation of the robotic thyroidectomy program in 2018, 889 cases have been performed, with an annual surgical volume of over 200 cases in the recent 3 years.^4,5 Postoperative complications have been minimal, with results comparable to those of conventional surgical approaches. These results demonstrate the safety and feasibility of robotic thyroidectomy via the BABA approach, which not only provides excellent oncological outcomes but also ensures minimal scarring and improved cosmetic results.

Conclusion:

Robotic thyroidectomy via the BABA approach represents a major advancement in thyroid cancer surgery. IONM and nano-carbon are available for use in robotic thyroidectomy. Robotic surgery provides a promising option for patients, ensuring excellent cosmetic results and faster recovery.

Acknowledgments:

Bo Wang, Wen-Yu Huang, and Jin-Yang Shi contributed equally to this work as co-first authors.

This research was supported by the Fujian Provincial Finance Project (Grant No.: 2023CZ008), Clinical Research Center for Precision Management of Thyroid Cancer of Fujian Province (Grant No.: 2022Y2006; 2024YGPT003) and Joint Funds for the Innovation of Science and Technology, Fujian Province (Grant No.: 2023Y9190; 2023Y9135; 2023Y9119).

An abstract based on this video was orally presented at the 19th Congress of the Asian Association of Endocrine Surgeons (AsAES 2025), 2025.4.1-5, AsAES, Seoul, South Korean.^1–5

The author(s) have received and archived patient consent for video recording/publication in advance of video recording of the procedure.

The authors declare no competing interests.

Runtime of video: 8 mins 55 secs.