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  • Title
  • 1. Introduction
  • 2. Marking and Surgical Approach
  • 3. Exposure
  • 4. Docking the Robot
  • 5. Subplatysmal Flap Dissection Under Direct Visualization
  • 6. Thyroid Dissection
  • 7. Closure
  • 8. Post-op Remarks

Robotic Thyroidectomy: A Bilateral Axillo-Breast Approach (BABA)

16032 views

Hyunsuk Suh, MD
The Mount Sinai Hospital

General SurgeryOtolaryngologyOncologic Surgery

Procedure Outline

Table of Contents

  1. 1. Introduction
    1. 2. Marking and Surgical Approach
      1. 3. Exposure
        1. 4. Docking the Robot
          1. 5. Subplatysmal Flap Dissection under Direct Visualization
            1. 6. Thyroid Dissection
              1. 7. Closure
                1. 8. Post-op Remarks
                  1. Position Patient
                  2. Examine Ultrasound
                  3. Mark Patient
                  1. Conduct Hydrodissection with Epinephrine Solution
                  2. Dissect Bluntly Using Clamps and Vascular Tunneler via Bilateral Peri-areolar and Axillary Incisions
                  3. Place Peri-areolar Trocars (8-12 mm)
                  4. Insufflate with CO2 (5-6 mmHg)
                  5. Place Axilla Trocars (8-12 mm)
                  1. Open the Strap Muscle at the Median Pharyngeal Raphe
                  2. Expose the Isthmus, Trachea, and Cricothyroid Cartilage
                  3. Dissect Strap Muscle with Medial Traction of Thyroid Down to the Carotid
                  4. Divide Sternohyoid from Sternothyroid Muscle
                  5. Dissect Strap Muscle with Medial Traction of Thyroid Down to the Carotid
                  6. Check Vagus Nerve Signal
                  7. Localize Recurrent Laryngeal Nerve (RLN)
                  8. Dissect along the RLN
                  9. Localize and Dissect Superior and Inferior Parathyroid Glands
                  10. Dissect Ligament of Berry and Isolate Superior Pole Vessels
                  11. Localize External Branch of Superior Laryngeal Nerve
                  12. Divide Superior Pole Vessels
                  13. Check Right Vagus Nerve and RLN Signal
                  14. Check for Hemostasis & Reapproximate Strap Muscles
                  15. Extend Axillary Incision
                  16. Remove Specimen via Endoscopic Retrieval Bag
                  1. Remove Robot and Trocars
                  2. Inject Local Anesthetic
                  3. Suture Incision Sites

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                  Authors

                  Filmed At:

                  The Mount Sinai Hospital

                  Article Information

                  Publication Date
                  Article ID212
                  Production ID0212
                  Volume2024
                  Issue212
                  DOI
                  https://doi.org/10.24296/jomi/212