Operative Technique for Single Incision Robot-Assisted Transaxillary Thyroid Surgery

During the past five years, transaxillary approaches to thyroid surgery have been introduced into surgical literature. These techniques were initially performed using traditional endoscopy, and most recently with a surgical robot. This manuscript describes our approach to robotassisted transaxillary surgery (RATS) for thyroidectomy using a single axillary incision. Because of the steep learning curve, this procedure is best implemented with a team approach. The ideal team consists of a console surgeon who operates the robot, a bedside surgeon who assists with retraction and troubleshoots robotic arm collisions and a circulating assistant who helps optimize the efficiency of the operation.