内镜机器人辅助甲状腺手术（BABA入路）七步法

Seven-step method for robot-assisted endoscopic thyroidectomy (BABA approach)

摘要:

传统开放甲状腺手术会在颈部留下疤痕而影响美观，因此，临床上开展了多种颈外入路的腔镜甲状腺手术。由于颈部解剖特点及腔镜器械的局限，各种常规内镜手术都存在一些不足，而内镜机器人辅助甲状腺手术可以弥补上述不足。目前，内镜机器人手术系统设备贵、手术费用高，还没有普及，多数医生对此还比较陌生，随着技术发展和费用降低，内镜机器人手术应用前景广阔。本文基于本中心多年来在腔镜甲状腺手术方面的规模化实践，结合国内外机器人甲状腺手术的经验与教训，总结并提出了经双侧腋窝乳晕入路的机器人辅助腔镜甲状腺手术七步操作流程，旨在为该技术的临床推广提供参考依据。

Abstract:

Traditional open thyroid surgery often leaves a scar on the neck, which can affect cosmetic outcomes. Therefore, various endoscopic thyroidectomy approaches via extra-cervical approaches have been developed. However, due to the unique anatomical characteristics of the neck and limitations of endoscopic instruments, conventional endoscopic techniques have certain drawbacks. Robot-assisted endoscopic thyroid surgery can help overcome these limitations. At present, robotic surgical systems remain expensive and the associated surgical costs are high, limiting their widespread adoption. Most surgeons are still relatively unfamiliar with the technique. Nevertheless, with ongoing technological advancements and cost reductions, robot-assisted surgery holds great promise for broader application. Based on years of large-scale experience in endoscopic thyroid surgery at our center, and drawing upon both domestic and international experiences with robotic thyroidectomy, this paper summarizes and proposes a seven-step protocol for robot-assisted endoscopic thyroidectomy via the bilateral axillo-breast approach, aiming to provide a practical reference for the clinical adoption of this technique.