The lumpectomy technique has been used for more than 20 years since the beginning of its application. Compared with traditional open surgery, lumpectomy can effectively reduce surgical trauma, postoperative pain, shorten hospital stay, and increase cosmetic results. However, the learning curve of lumpectomy is unique, and surgeons need considerable training time to master and apply the technique. The main reasons for this are the long lumpectomy instruments, which are introduced into the body through a relatively fixed entrance to achieve eye-hand coordination through the observation screen, increasing the difficulty of fine motor control, the small surgical space affecting the smooth performance of complex operations, and the increased difficulty of hand-eye coordination through screen observation. The long, straight instruments that cannot be bent limit their mobility and direction of movement in the body, and the two-dimensional imaging system results in a lack of depth perception, so that basic movements such as suturing and knotting require long training to be completed under the lumpectomy. In addition, the observation mirror in the lumpectomy system acts as the surgeon’s eye, which usually needs to be controlled by the assistant, and the assistant is easily fatigued when holding the mirror during a long and complicated surgery. This can affect the smooth performance of the surgery. The robotic lumpectomy system can overcome the above-mentioned shortcomings of traditional lumpectomy, increase surgeon’s efficiency, improve surgical results, and make some surgical operations that are difficult to complete under traditional lumpectomy easy to operate. At present, the main technically mature and commercially available robotic lumpectomy system is the da Vinci® surgical system, which was designed and manufactured by Intuitive Surgical, Inc. in 1995 and used in clinical surgical research, and passed FDA safety verification in 2000. In 2000, it passed the FDA safety verification and began to be widely used. The system consists of a console, a robotic arm, and a high-resolution 3-D video surveillance system. The operating instruments are connected to the robotic arm and inserted into the body through the Trocar, and the surgeon operates the surgical instruments through the console. da Vinci imaging system consists of dual cameras, which can form a three-dimensional image with binocular vision and can be magnified 10-15 times. The surgeon sits at the console to control the robot while viewing the 3-D surgical image through binoculars (Figure 1). The degree of hand-eye coordination of the integrated computer synthesis fully meets or even exceeds the results of open surgery. The endowrist design of the operating instruments in the da Vinci system increases the flexibility of operation (Figure 2), allowing the surgeon’s entire movement to be translated into precise robotic movements in real time, surpassing the limits of human joint movement and exceeding the fineness of open surgery. The external arm provides three directions of movement: forward and backward, rotation, and lateral movement, and the internal joint provides four degrees of freedom: up and down, lateral movement, rotation, and opening and closing (pitch, yaw, rotation, and grip). It can rotate 360° in the vertical axis and 270° in the horizontal axis, and each joint can move > 90°. Especially in deep operation, it has significant advantages over manual operation in open surgery due to its flexibility and compact size. At the same time, the robot arm has a computer-aided position memory function, which can quickly and precisely return to the position before replacing the instrument, and has the characteristics of “plug-and-play and seamless connection”. In addition, the control principle of the robot is intuitive control, and the direction of the action under the mirror is the same as the direction of the hand control, and the action image is positive image, while the mirror image movement is in the traditional lumpectomy. This eliminates the fulcrum effect in conventional lumpectomy, where the surgeon needs to move in reverse to perform the correct operation. The robotic system can scale down the surgeon’s motion to achieve precise operation by overlooking ineffective jitter. The human-machine control interface eliminates Trocar resistance and prevents operator fatigue. This is especially important for complex procedures that require prolonged operation. In traditional lumpectomy, surgeons often need to stand for long periods of time and constantly twist their bodies and wrists in different postures and hand positions to perform complex operations, making the procedure particularly fatiguing for less experienced beginners, thus affecting the quality and outcome of the procedure. During robot-assisted surgery, the surgeon sits in a very comfortable position in front of the console and is able to operate for long periods of time without fatigue. However, robotic surgery still requires a skilled surgical assistant in a sterile gown at the patient’s bedside, whose responsibilities include changing instruments on the robotic arm, suctioning and rinsing, inserting and removing sutures, and assisting with visualization of the operative field. Conventional lumpectomy allows for the removal of benign thyroid nodules, partial or total thyroidectomy, and even lymph node dissection for thyroid cancer. However, because there is no natural cavity like the abdominal cavity in thyroid lumpectomy, the artificially created operation space is relatively small, and the two-dimensional image under the mirror and the long straight instruments that cannot be bent make the operation technique more difficult and the learning curve longer, and the chance of laryngeal nerve injury or parathyroid gland injury increases if the technique is not skilled or operated carefully during thyroid surgery. Therefore, the use of conventional lumpectomy in thyroid surgery is still not popular. The advantages of using robot-assisted axillary approach for radical thyroid cancer surgery include: the viewpoint when performing lateral cervical lymph node dissection is the same as that of open surgery, the upper and lower poles of the thyroid are easily revealed and handled, there is no postoperative numbness and fibrous tissue contraction in the anterior cervical region, the axillary incision is concealed, the cosmetic effect is excellent, and lateral cervical lymph node dissection can be completed. Secondly, the operating space established by the retraction method can be used to remove smoke and bleeding by continuous negative pressure suction, providing a stable and clear surgical field. The lateral view directly reveals the parathyroid gland and the recurrent laryngeal nerve, ensuring that thyroidectomy and lymph node dissection can be done safely in a small space. The axillary incision is extremely concealed and has significant postoperative cosmetic advantages. The results of this study suggest that the robotic-assisted lumpectomy system can be a reliable option for most patients with thyroid cancer, allowing for the same delicate cervical lymph node dissection as open surgery, but with the same cosmetic results as conventional lumpectomy. Robotic surgery with an axillary approach may be superior to the combined axillary-breast approach in terms of operative time, extent and thoroughness of lymph node dissection, while the latter is superior in terms of completeness of contralateral thyroid excision. In addition to the limitations of the surgical approach itself, the proficiency of the surgical technique may also be one of the main reasons for this difference. The Breast Center of Southwest Hospital is the first unit in China to apply the robotic lumpectomy technology to the surgical treatment of thyroid cancer, and has accumulated rich experience in robotic surgery for benign thyroid tumors and thyroid cancer. Compared with open surgery and traditional lumpectomy, the surgical field is clearer, the operation is more flexible and less traumatic, the operation is more thorough, the postoperative complication rate is lower, the postoperative recovery is faster, and the hospital stay is shorter. As a new technology in the development of lumpectomy, robotic lumpectomy will bring new opportunities for thyroid surgery.