目的：总结机器人辅助甲状腺手术经双侧乳晕和腋窝途径（Bilateral axillo-breast approach，BABA）入路手术过程中助手的操作要点，并分析学习曲线。方法：回顾性分析 2014 年 2 月 ~2015 年 1 月中国人民解放军第960医院开展机器人辅助下经 BABA入路甲状腺手术患者 50例的临床资料，统计装机时间、标本取出时间等临床资料。根据学习曲线将病例分为新手期及熟练期两组，分析两组患者临床资料及术后并发症情况。结果：手术量积累到 23例后，装机时间缩短并趋于平稳，维持在（41.67±9.50）min；手术量积累到 21 例后，取标本时间缩短并趋于平稳，维持在（1.36±1.06）min。两组患者年龄、性别、肿瘤良 / 恶性比例、手术单 / 双侧腺叶切除资料比较，差异无统计学意义（P>0.05）；而装机时间与取标本时间差异有统计学意义（P<0.05）。装机时间与性别、年龄、肥胖及女性是否哺乳有关；取标本时间与性别、年龄有关，而与肥胖及女性是否哺乳无关。结论：机器人辅助下经 BABA 入路甲状腺手术助手学习曲线约为 20 例，一名合格的助手可帮助缩短手术时间并减少术后并发症。
Objective: To summarize key points of operation to the assistant during robotic thyroid surgery under BABA approach, and analyze the learning curve. Methods: 50 cases of robotic thyroidectomy using bilateral axillo-breast approach (BABA) in our hospital from February 2014 to January 2015 were retrospectively analyzed. Data on installation time, sampling time and complications were collected and analyzed. Results: The installation time began to be shortened and stable after 23 cases of surgeries by maintaining at 41.67±9.50min, while the sampling time was 21 cases at 1.36±1.06min. No significant differences were found between the two groups on age, sex, ration of benign tumor to malignant, ratio of unilateral adenectomy to bilateral（P>0.05）. The difference between installing time and sampling time was statistically significant（P<0.05）. Conclusion: The learning curve of assistant in robotic thyroidectomy with BABA approach was about 20 cases.