Feasibility and safety of transaxillary robotic thyroidectomy in Japan – Comparison with video-assisted neck surgery in initial cases

Objective : To evaluate the safety and feasibility of transaxillary robotic thyroidectomy (TART) in Japan by comparing early cases with video-assisted neck surgery (VANS). Methods : Single-center retrospective review of 31 consecutive thyroid lobectomies: 16 VANS (Nov 2020–Feb 2025) and 15 TART (Mar 2022–Feb 2025). TART used da Vinci Surgical system (da Vinci) Xi for early cases and predominantly da Vinci SP thereafter. Indications included differentiated cancer ≤4 cm, cN0, unilateral disease without extrathyroidal invasion, or follicular tumors 3–5 cm. Operative time, blood loss, hospital stay, complications, and cosmetic outcomes were evaluated and compared with statistical analysis. Results : All procedures were completed without conversion to open surgery. Blood loss (16.5 g vs 25.8 g) and length of stay (6.3 vs 6.1 days) were comparable. Complications included two transient recurrent laryngeal nerve palsies after VANS and, after TART, one axillary bleed controlled under local anesthesia and one lymphatic leak; overall rates were similar. High cosmetic satisfaction was reported in both cohorts. Conclusion : Early experience shows TART is feasible and safe in Japan, achieving perioperative outcomes comparable to VANS with excellent cosmetic results.