There are many different techniques to remove the thyroid gland. These different techniques have various pros and cons. The large number of possible ways to do a thyroidectomy or parathyroidectomy suggest that most patients would prefer to avoid a scar on their neck. One technique, known as BABA (Bilateral Axillo-Breast Approach) uses a robot to access the thyroid via 4 incisions on the breast and in the axilla (armpit).
This technique was common prior to the development of the newer transoral "scarless" technique (known as TOETVA) which we use primarily at the Russell Center.
While there are advantages and disadvantages to the BABA technique, over time, TOETVA has become more popular and is more widely accepted around the world. By looking down into the neck from the transoral approach, surgeons are more clearly able to see any lymph nodes that might be hiding inferior to the thyroid. Also, the amount of dissection is much shorter and drains are not normally required.
At the Russell Center, we have explored all of the current techniques (TOAST, BABA, Retroauricular, etc) and have found that only the transoral technique has no incisions that are visible. As such, cosmetic satisfaction is the highest according to multiple studies, and that has become our standard approach. Dr Russell has done more remote access surgeries than any other surgeon in North and South America over the last 10 years.
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