OBJECTIVE To evaluate the feasibility and safety of robotic-assisted breast-axillo insufflation thyroidectomy (RABIT) for differentiated thyroid cancer. METHODS In this retrospective case series, patients with differentiated thyroid carcinoma were enrolled in our hospital from January 2018 to December 2018. All patients underwent indirect laryngoscopy to assess the status of vocal cord preoperatively. RABIT was performed with five separate breast-axillo incisions. All the procedures were performed using da Vinci Xi Robotic Surgical System, a single docking method using CO2 insufflation. RESULTS Twelve patients completed RABIT, in which one case needed conversion to open thyroidectomy. The mean age was 30.25 ± 7 with male to female ratio being 1:1. Preoperative diagnosis showed papillary carcinoma (n = 9) and follicular neoplasm (n = 3). The mean operative time for RABIT was 140 ± 50.45 min and average blood loss during surgery was 22.92 ± 9 mL. Mean hospital stay was 4.42 ± 1.08 days. Final pathology confirmed classical papillary thyroid carcinoma (n = 10; 83.3%) and follicular variant of papillary carcinoma (n = 2; 16.7%). None of the cases reported injury or paralysis to the recurrent laryngeal nerves. CONCLUSION RABIT is a safe and feasible approach for thyroidectomy. It has several advantages in that it provides similar symmetrical view to conventional open surgery and enables to maintain specimen integrity and use of assistant port permits better handling of the gland. Additionally, the largest operating angles with this technique prevent collision between the robotic arms and provide excellent cosmetic satisfaction due to very small, five separate breast-axillo incisions.

中文翻译：

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机器人辅助腋下气肿性甲状腺切除术（RABIT）：甲状腺癌的回顾性病例系列。

目的评估机器人辅助腋下吹气式甲状腺切除术（RABIT）治疗分化型甲状腺癌的可行性和安全性。方法在此回顾性病例系列中，我院于2018年1月至2018年12月纳入分化型甲状腺癌患者。所有患者均接受间接喉镜检查以评估术前声带的状况。用五个单独的乳头腋窝切口进行了RABIT。所有程序均使用da Vinci Xi机器人手术系统执行，这是使用CO2吹入的单一对接方法。结果12例患者完成了RABIT，其中1例需要转换为开放性甲状腺切除术。平均年龄为30.25±7，男女之比为1：1。术前诊断为乳头状癌（n = 9）和滤泡状肿瘤（n = 3）。RABIT的平均手术时间为140±50.45分钟，手术期间的平均失血量为22.92±9 mL。平均住院天数为4.42±1.08天。最终病理证实为经典乳头状甲状腺癌（n = 10； 83.3％）和滤泡型乳头状癌（n = 2； 16.7％）。没有病例报告喉返神经受伤或麻痹。结论RABIT是甲状腺切除术安全可行的方法。它具有几个优势，因为它提供了与常规开放手术相似的对称视图，并能够保持标本完整性，并且使用辅助端口可以更好地处理腺体。此外，这种技术的最大操作角度可防止机械臂之间发生碰撞，并且由于非常小的五个单独的乳房腋窝切口而提供了出色的美容效果。