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Video preload image for Robotic Thyroidectomy: A Bilateral Axillo-Breast Approach (BABA)
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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)

15763 views

Hyunsuk Suh, MD
The Mount Sinai Hospital

Procedure Outline

  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