Abstract: Objective To explore the surgical safety and oncological completeness of da Vinci robotic thyroidectomy via bilateral axillary approach for children and adolescents with thyroid cancer. Methods The clinical data of 45 cases of thyroid cancer treated with da Vinci robotic thyroidectomy were collected and reviewed. The patients included 12 boys and 33 girls, aged 13 to 22 years, average(18.49±3.38)years. The surgical safety and oncological completeness were evaluated postoperatively. All patients were followed up by outpatient visits and telephone calls. The cosmetic outcomes were evaluated with numerical scoring system 1 month after operation. Results All operations were successful, with no conversion to open surgery. An average of 17.4 lymph nodes in the central area/case were resected, 5.9 of which were positive; an average of 18 lymph nodes/case in the lateral area were resected, 4.6 of which were positive. No serious complications such as permanent recurrent laryngeal nerve injury, hypoparathyroidism, hemorrhage or chylous leakage occurred. The average hospital stay was(6.9±0.4)days. In a postoperative follow-up of 1 to 64 months, the incision cosmetic score was(9.6±0.3). No recurrence happened. Conclusion The da Vinci robotic thyroidectomy via bilateral axillary breast approach is safe and effective for the treatment of thyroid cancer in children and adolescents. It can leave no scar on patients neck, achieve satisfactory cosmetic effects, reduce postoperative psychological trauma, and improve patients quality of life.

Key words: da Vinci surgical system, Children and adolescents, Thyroid cancer, Thyroidectomy