Truly Scarless Three-Port Transoral Robotic Thyroidectomy: A Feasible and Efficient Alternative to the Four-Port Approach for Thyroid Cancer Patients.

Abstract

Transoral robotic thyroidectomy (TORT) has traditionally used a four-port technique. The original three-port approach, which eliminates the axillary port, makes TORT truly scarless. This study compares outcomes between these techniques. A retrospective review was conducted on consecutive patients who underwent TORT lobectomy for thyroid cancer between August 2021 and January 2025. The four-port technique was used until January 2024, after which only the three-port technique was performed. Thirty (M:F 6:24) and 59 (M:F 8:51) patients were included in the four-port and three-port groups, respectively. The three-port group had a significantly shorter operation time (107.1 vs. 141.0 min, p < 0.001). Transient recurrent laryngeal nerve injury occurred in one four-port case, while the three-port group had one seroma and one wound inflammation. No cases of conversion to open surgery were observed. Truly scarless three-port TORT is a feasible and efficient alternative and may replace four-port TORT for selected thyroidectomy patients.