Comparative analysis of 2 robotic thyroidectomy procedures: Transoral versus bilateral axillo-breast approach

Background: The surgical outcomes of a single surgeon's initial cases of transoral robotic thyroidectomy (TORT) were compared with the surgeon's initial cases of a bilateral axillo-breast approach (BABA) robotic thyroidectomy. Methods: The medical reports were retrospectively reviewed. The BABA robotic thyroidectomies were performed between 2008 and 2009, and TORTs were performed between 2012 and 2016. Results: Each group comprised 50 patients. Operative time for total thyroidectomy was shorter, the pain scores were lower, and hospital stays were shorter in the TORT group than in the BABA robotic thyroidectomy group. There were no significant differences between groups in either vocal cord palsy or hypoparathyroidism rates. There were 9 cases of mental nerve injury in the first 12 cases of TORT, but none subsequently. Conclusion: The TORT procedure could be performed safely and showed comparable outcomes with BABA robotic thyroidectomy in selected patients. Therefore, TORT may be an alternative approach for patients who prefer a scar-free thyroidectomy.