Surgery Today

, Volume 49, Issue 5, pp 420–426 | Cite as

The application of subcapsular saline injection during bilateral axillo-breast approach robotic thyroidectomy: a preliminary report

  • Hyeong Won Yu
  • In Eui Bae
  • Jin Wook Yi
  • Joon-Hyop Lee
  • Su-jin Kim
  • Young Jun Chai
  • June Young ChoiEmail author
  • Kyu Eun Lee
Original Article



Saving the parathyroid gland during robotic thyroidectomy is challenging. This study evaluated the application of a novel method, subcapsular saline injection (SCASI), to save the parathyroid gland during bilateral axillo-breast approach (BABA) robotic total thyroidectomy.


Of the 81 included patients operated on from 2014 to 2016, 31 and 50 underwent BABA robotic total thyroidectomy with and without SCASI, respectively. Serum concentrations of parathyroid hormone (PTH), calcium, and ionized calcium were measured at 1 day and 9 months postoperatively. Transient hypoparathyroidism was defined as PTH < 10.0 pg/mL after 1 day and permanent hypoparathyroidism as PTH < 15.0 pg/mL at 9 months.


There were no significant clinicopathologic differences between the two groups. The rate of transient hypoparathyroidism was significantly lower in the SCASI group than in the non-SCASI group [16.1% (5/31) vs. 44% (22/50), p < 0.01]. However, the rates of permanent hypoparathyroidism [0% (0/31) vs. 4% (2/50), p = 0.699] did not differ significantly.


SCASI is a feasible and safe method of saving the parathyroid gland during BABA robotic total thyroidectomy.


Bilateral axillo-breast approach Robotic thyroidectomy Parathyroid SCASI Subcapsular saline injection 



This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Science, ICT & Future Planning, Republic of Korea (Grant number: 2015R1C1A1A01055464).

Compliance with ethical standards

Conflict of interest

Hyeong Won Yu, In Eui Bae, Jin Wook Yi, Joon-Hyop Lee, Su-jin Kim, Young Jun Chai, June Young Choi, and Kyu Eun Lee have neither actual nor potential conflicts of interest to declare.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of SurgerySeoul National University Bundang HospitalSeongnam-siSouth Korea
  2. 2.Department of SurgerySeoul National University Hospital and College of MedicineSeoulSouth Korea
  3. 3.Department of SurgeryGachon University College of Medicine, Gil Medical CenterIncheonSouth Korea
  4. 4.Department of SurgerySeoul National University Boramae Medical CenterSeoulSouth Korea

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