Not all patients need a robot: comparative perioperative outcomes of robotic BABA versus endoscopic CABBA…

Cohort studyJournal of robotic surgery· Jul 2026

Not all patients need a robot: comparative perioperative outcomes of robotic BABA versus endoscopic CABBA thyroid lobectomy with ipsilateral central lymph node dissection, stratified by body mass index.

Ting Yan, Zheng Ding, Rui Xiao … Zhili Yang

Surgical Outcomes & RecoveryCohort studyTreatmentQ1IF 4.0

In overweight patients, robotic approach associated with higher lymph node yield than endoscopic surgery

Not all patients need a robot: comparative perioperative outcomes of robotic BABA versus endoscopic CABBA thyroid lobectomy with ipsilateral central lymph node dissection, stratified by body mass index.

Ting Yan … Zhili Yang

Journal of robotic surgery · Jul 2026 · Q1 in Surgery

Background

Endoscopic thyroid surgery is increasingly used for papillary thyroid carcinoma (papillary thyroid carcinoma), but whether robotic bilateral axillo-breast approach (bilateral axillo-breast approach) offers meaningful perioperative advantages over endoscopic contralateral axillo-bilateral-breast approach (contralateral axillo-bilateral-breast approach) for unilateral lobectomy with ipsilateral central lymph node dissection (central lymph node dissection) is unclear.

Purpose

This retrospective cohort study at Shanghai Sixth People's Hospital (2021-2025) aimed to compare outcomes between robotic bilateral axillo-breast approach and endoscopic contralateral axillo-bilateral-breast approach after lobectomy plus ipsilateral central lymph node dissection for papillary thyroid carcinoma, stratified by body mass index (BMI: <24 vs. ≥ 24 kg/m²).

Results

robotic surgery removed more lymph nodes in heavier patients

MD -4 (95% CI -8 to -1)

CI excludes the null - significant

More results

Propensity score matching was applied within each BMI stratum.

Endoscopic contralateral axillo-bilateral-breast approach retained cost and cosmetic advantages in both strata (both P < 0.001).

In overweight/obese patients, robotic bilateral axillo-breast approach improves central lymph node clearance.

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Conclusion

These findings support BMI‑based patient selection for robotic thyroidectomy.

Not all patients need a robot: comparative perioperative outcomes of robotic BABA versus endoscopic CABBA thyroid lobectomy with ipsilateral central lymph node dissection, stratified by body mass index.

Not all patients need a robot: comparative perioperative outcomes of robotic BABA versus endoscopic CABBA thyroid lobectomy with ipsilateral central lymph node dissection, stratified by body mass index.

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