Robotic total thyroidectomy using the gas-insufflation one-step single-port transaxillary (GOSTA) Approach: Single-port vs. sequential contralateral single-port technique

초록

Background: With the introduction of the da Vinci SP system, conventional approaches such as BABA, transoral, and transaxillary have been adapted to the single-port platform, leading to the development of new robotic thyroidectomy techniques. This study builds on our previous work with the gas-insufflation one-step single-port transaxillary (GOSTA) approach and compares a true single-port technique (SPT) with the sequential contralateral single-port technique (SCSPT) for total thyroidectomy. Methods: This retrospective study included a total of 67 patients who underwent total thyroidectomy with or without neck dissection at a single institution between January 2022 and March 2025. Among them, 31 patients underwent surgery using the SPT, while 36 patients were treated with the SCSPT. Results: All patients underwent contralateral lobectomy following ipsilateral lobectomy. The mean contralateral lobectomy time was significantly shorter in the SPT group than in the SCSPT group (51.0 ± 14.1 vs. 67.5 ± 27.6 minutes, p = 0.003). Consequently, the total operative time for total thyroidectomy was also shorter in the SPT group (124.4 ± 27.9 vs. 148.9 ± 45.0 minutes, p = 0.011). No significant differences were observed between the two groups in other pathophysiologic characteristics or postoperative complications. Conclusions: The SPT appears to be a safe and feasible alternative to the conventional SCSPT, with a tendency toward shorter operative times.