Bilateral
Axillo-Breast
Approach

Endoscopic BABA Is Born at SNUH

At Seoul National University Hospital, Yeo-Kyu Youn performs the world's first BABA endoscopic thyroidectomy — a symmetric four-port route to the thyroid through both axillae and both areolae. The technique itself is born; the world will hear about it three years later.

The Original BABA Paper

Choe, Youn and colleagues publish the formal description of BABA endoscopic thyroidectomy in World J Surg — the foundational reference cited by every subsequent BABA paper. Three years after the first SNUH case, the technique enters the global surgical literature.

The First BABA Robotic Thyroidectomy

On 13 May 2008, at Seoul National University Bundang Hospital, the team performs the world's first BABA robotic thyroidectomy — a total thyroidectomy carried out via the da Vinci surgical system through the four BABA ports. The 3D magnified field, articulated EndoWrist instruments and tremor filtration resolve the technical fragilities of the endoscopic predecessor. BABA enters the robotic era.

Robotic BABA Proves Oncologic

Lee KE et al. publish the first dedicated oncologic outcome series — 109 papillary thyroid carcinoma patients undergoing robotic total thyroidectomy with central node dissection via BABA — establishing the operation as a true cancer procedure, not merely a cosmetic alternative.

A Thousand Cases & the Endoscopic Foundation

On 3 January 2012, the SNUH BABA team marks its 1,000th robotic thyroidectomy — the first institution worldwide to reach the milestone via remote-access robotic surgery.

In the same year, Choi JY et al. publish a review of 512 consecutive endoscopic BABA cases — the largest pre-robotic single-institution series, defining the safety profile of the four-port approach.

Surgical Completeness Confirmed

Lee KE et al. cross the thousand-case threshold — 1,026 consecutive BABA robotic thyroidectomies with formal evaluation of surgical completeness. Oncologic quality scales with experience and remains equivalent to the open standard.

The Operative Atlas

On 26 February 2014, Springer publishes Color Atlas of Thyroid Surgery — Open, Endoscopic and Robotic Procedures, authored by Yeo-Kyu Youn, Kyu Eun Lee and June Young Choi. The first dedicated atlas to document the complete BABA robotic technique step by step — codifying a decade of SNUH experience into a reproducible operative reference for surgeons worldwide.

The ATA Endorses Remote-Access

The American Thyroid Association Surgical Affairs Committee (Berber, Bernet, Tufano et al.) issues its official statement on remote-access thyroid surgery — explicitly recognizing BABA as one of the legitimate techniques. The moment BABA moves from regional innovation to globally accepted surgical option.

The Size Ceiling Breaks

Chai YJ et al. demonstrate the surgical safety and oncological completeness of BABA RT for thyroid carcinomas larger than 2 cm — pivotal in expanding remote-access surgery beyond microcarcinoma into mainstream thyroid cancer.

BABA Becomes Image-Guided

Yu HW et al. integrate indocyanine green fluorescence with the da Vinci Firefly® system to localize parathyroid glands in real time — turning parathyroid preservation from a learned visual skill into a near-deterministic technical step.

From Thyroid to Whole-Neck Operation

Yu HW et al. extend BABA to a complete modified radical neck dissection for papillary thyroid carcinoma with lateral nodal metastasis — performed through the same four ports. BABA matures into a viable alternative for clinically node-positive disease.

BABA Crosses Into Europe

Mercader Cidoncha et al. describe the introduction of BABA at a specialized unit in Spain, accompanied by a comprehensive literature review — tangible evidence of BABA crossing from Asia into Europe and being adopted as a credible scarless option in Western practice.

The 5,000-Case Commemorative Symposium

On 12 November 2021, Seoul National University Hospital hosts the "BABA Robotic Thyroidectomy 5,000-Case Commemorative Symposium" — held as a hybrid on/offline event during the COVID-19 pandemic. Surgeons, trainees and collaborators gather to mark the milestone and preview "Advanced Robotic Surgery: the Present and Future of Precision Surgery". The clinical foundation for the definitive 5,000-case publication two years later.

The Definitive Time-Trend Analysis

Kwak J, Yu HW, Choi JY and Lee KE publish the analysis of 5,011 consecutive BABA RT cases across three SNU-affiliated hospitals over fourteen years — the largest single-program experience of remote-access RT ever published. Documents expanding indications and falling complication rates across four generations of the da Vinci system. World J Surg · December 2022 (online) / 2023 (print).