title: Bilateral axillo-breast approach robotic thyroidectomy for Graves' disease: an initial experience in a single institute.
abstract: BACKGROUND
  Bilateral axillo-breast approach (BABA) robotic thyroidectomy has shown excellent cosmetic and surgical outcomes. The aim of the present study was to evaluate the safety, feasibility, and initial outcome of this procedure in patients with Graves' disease.
  
  
  METHODS
  From June 2008 to July 2001, a total of 30 patients with Graves' disease were reviewed retrospectively. Patient demographics, operative indications, and surgical variables, including operative time, blood loss, excised thyroid weight, and complications, were collected and investigated.
  
  
  RESULTS
  The thyroidectomies were classified as total (n = 21), near-total (n = 6), or subtotal (n = 3). There were five indications for surgery: concomitant thyroid carcinoma or suspicious nodule (n = 22), recurrence after antithyroid medication (n = 2), local compressive symptoms (n = 1), patient's preference (n = 4), and side effects of antithyroid medication (n = 1). The mean operative time, console time, blood loss, and excised thyroid weight were 190 min (range: 105-298 min), 113 min (range: 60-227 min), 229 mL (range: 50-550 mL), and 36.6 g (range: 7.8-123.0 g), respectively. There were no cases of postoperative bleeding or conversions to open surgery. Postoperative transient hypoparathyroidism and vocal cord palsy occurred in 13 (43.3 %) and 4 (13.3 %) cases. Permanent hypoparathyroidism occurred in 1 (3.3 %) case. All patients were satisfied with the cosmetic outcomes.
  
  
  CONCLUSIONS
  BABA robotic thyroidectomy is a feasible and safe treatment for Graves' disease. It is recommended as an alternative for patients who are concerned by the cosmetic effects of traditional thyroidectomy.
authors.affiliation: Department of Surgery, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, South Korea. lovekkung@gmail.com
authors.forename: Hyungju
authors.initials: H
authors.lastname: Kwon
authors.forename: Do Hoon
authors.initials: do H
authors.lastname: Koo
authors.forename: June Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Eunyoung
authors.initials: E
authors.lastname: Kim
authors.forename: Kyu Eun
authors.initials: KE
authors.lastname: Lee
authors.forename: Yeo-Kyu
authors.initials: YK
authors.lastname: Youn
mesh_terms: D000328:Adult; D001365:Axilla; D001940:Breast; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012371:Robotics; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome
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