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1. Introduction
2. Marking and Surgical Approach
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a. Position Patient
b. Examine Ultrasound
c. Mark Patient
3. Exposure
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a. Conduct Hydrodissection with Epinephrine Solution
b. Dissect Bluntly Using Clamps and Vascular Tunneler via Bilateral Peri-areolar and Axillary Incisions
c. Place Peri-areolar Trocars (8-12 mm)
d. Insufflate with CO2 (5-6 mmHg)
e. Place Axilla Trocars (8-12 mm)
4. Docking the Robot
5. Subplatysmal Flap Dissection under Direct Visualization
6. Thyroid Dissection
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a. Open the Strap Muscle at the Median Pharyngeal Raphe
b. Expose the Isthmus, Trachea, and Cricothyroid Cartilage
c. Dissect Strap Muscle with Medial Traction of Thyroid Down to the Carotid
d. Divide Sternohyoid from Sternothyroid Muscle
e. Dissect Strap Muscle with Medial Traction of Thyroid Down to the Carotid
f. Check Vagus Nerve Signal
g. Localize Recurrent Laryngeal Nerve (RLN)
h. Dissect along the RLN
i. Localize and Dissect Superior and Inferior Parathyroid Glands
j. Dissect Ligament of Berry and Isolate Superior Pole Vessels
k. Localize External Branch of Superior Laryngeal Nerve
l. Divide Superior Pole Vessels
m. Check Right Vagus N. and RLN Signal
n. Check for Hemostasis & Reapproximate Strap Muscles
o. Extend Axillary Incision
p. Remove Specimen via Endoscopic Retrieval Bag
7. Closure
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a. Remove Robot and Trocars
b. Inject Local Anesthetic
c. Suture Incision Sites
8. Post-op Remarks
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Robotic Thyroidectomy: A Bilateral Axillo-Breast Approach (BABA)
Hyunsuk Suh, MD
The Mount Sinai Hospital
Tags:
Otolaryngology
General Surgery
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Authors
Hyunsuk Suh, MD
Filmed At:
The Mount Sinai Hospital
Article Information
Publication Date
N/A
Article ID
212
Production ID
0212
Volume
N/A
Issue
212
DOI
https://doi.org/10.24296/jomi/212