Online Article: Technical ReportThe First Report of Robotic Bilateral Modified Radical Neck Dissection Through the Bilateral Axillo-breast Approach for Papillary Thyroid Carcinoma With Bilateral Lateral Neck MetastasisSong, Ra-Yeong MD*; Sohn, Hee Ju MD*; Paek, Se Hyun MD†; Kang, Kyung Ho MD, PhD*Author Information *Department of Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine †Department of Surgery, Ewha Womans University College of Medicine, Seoul, Korea R.-Y.S. and H.J.S. contributed equally. The authors declare no conflicts of interest. Reprints: Kyung Ho Kang, MD, PhD, Department of Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Korea (e-mail: firstname.lastname@example.org). Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: June 2020 - Volume 30 - Issue 3 - p e18-e22 doi: 10.1097/SLE.0000000000000590 Buy Metrics Abstract Background: Robotic unilateral modified radical neck dissection (MRND) has been reported to be safe and achieves good oncologic results. However, there is no report of successful robotic bilateral MRND to date. We report the first case series of robotic bilateral MRND through the bilateral axillo-breast approach (BABA). Methods and Results: We reviewed 4 patients who presented with papillary thyroid cancer and metastasis to both lateral neck compartments. BABA robotic total thyroidectomy with bilateral MRND was performed. There were no incidences of vocal cord palsy, permanent hypoparathyroidism, or chyle leakage. All patients underwent high-dose radioiodine ablation. At last follow-up, imaging tests showed no recurrence and thyroglobulin levels remained low. Conclusions: BABA allows complete compartment-oriented neck dissection with outcomes that may be comparable with open bilateral MRND. BABA robotic surgery could be a good alternative for patients with papillary thyroid cancer and bilateral neck metastasis who wish to avoid long neck scar. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.