Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Robotic harvest of a latissimus dorsi flap using a single-port surgical robotic system in breast reconstruction

  • Joo, Oh Young (Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine) ;
  • Song, Seung Yong (Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine) ;
  • Lew, Dae Hyun (Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine) ;
  • Park, Hyung Seok (Department of Surgery, Yonsei University College of Medicine) ;
  • Lee, Dong Won (Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine)
  • Received : 2021.04.29
  • Accepted : 2021.06.16
  • Published : 2021.11.15
Download PDF
⟨ Previous Next ⟩

Abstract

Robot-assisted surgery is evolving to incorporate a higher number of minimally invasive techniques. There is a growing interest in robotic breast reconstruction that uses autologous tissue. Since a traditional latissimus dorsi (LD) flap leads to a long donor scar, which can be an unpleasant burden to patients, there have been many attempts to decrease the scar length using minimally invasive approaches. This study presents the case of a patient who underwent a robot-assisted nipple-sparing mastectomy followed by immediate breast reconstruction with an LD flap using a single-port robotic surgery system. With the assistance of a single-port robot, a simple docking process using a short and less visible incision is possible. Compared to multiport surgery systems, single-port robots can reduce the possibility of collision between robotic arms and provide a clear view of the medial border of the LD where the curvature of the back restricts the visual field. We recommend the use of single-port robots as a minimally invasive approach for harvesting LD flaps.

Keywords

References

  1. Selber JC, Baumann DP, Holsinger FC. Robotic latissimus dorsi muscle harvest: a case series. Plast Reconstr Surg 2012;129:1305-12. https://doi.org/10.1097/PRS.0b013e31824ecc0b
  2. Agarwal DK, Sharma V, Toussi A, et al. Initial experience with da Vinci single-port robot-assisted radical prostatectomies. Eur Urol 2020;77:373-9. https://doi.org/10.1016/j.eururo.2019.04.001
  3. Ahn SJ, Song SY, Park HS, et al. Early experiences with robot-assisted prosthetic breast reconstruction. Arch Plast Surg 2019;46:79-83. https://doi.org/10.5999/aps.2018.00052
  4. Fine NA, Orgill DP, Pribaz JJ. Early clinical experience in endoscopic-assisted muscle flap harvest. Ann Plast Surg 1994;33:465-9. https://doi.org/10.1097/00000637-199411000-00001
  5. Bass LS, Karp NS, Benacquista T, et al. Endoscopic harvest of the rectus abdominis free flap: balloon dissection in the fascial plane. Ann Plast Surg 1995;34:274-9. https://doi.org/10.1097/00000637-199503000-00009
  6. Chung JH, You HJ, Kim HS, et al. A novel technique for robot assisted latissimus dorsi flap harvest. J Plast Reconstr Aesthet Surg 2015;68:966-72. https://doi.org/10.1016/j.bjps.2015.03.021
  7. Lee J, Park HS, Lee H, et al. Axillary lymph node dissection using a robotic surgical system: initial experience. J Surg Oncol 2020;122:1252-6. https://doi.org/10.1002/jso.26141
  8. Chang HP, Fan KL, Song SY, et al. The traditional versus endoscopic-assisted latissimus dorsi harvest in oncoplastic surgery: a long term comparison of breast volume, aesthetics, and donor site outcomes. Asian J Surg 2020;43:1165-71. https://doi.org/10.1016/j.asjsur.2020.03.002
  9. Clemens MW, Kronowitz S, Selber JC. Robotic-assisted latissimus dorsi harvest in delayed-immediate breast reconstruction. Semin Plast Surg 2014;28:20-5. https://doi.org/10.1055/s-0034-1368163
  10. Lee WY, Kim MJ, Lew DH, et al. Three-dimensional surface imaging is an effective tool for measuring breast volume: a validation study. Arch Plast Surg 2016;43:430-7. https://doi.org/10.5999/aps.2016.43.5.430
  11. Park HS, Lee J, Lee DW, et al. Robot-assisted nipple-sparing mastectomy with immediate breast reconstruction: an initial experience. Sci Rep 2019;9:15669. https://doi.org/10.1038/s41598-019-51744-2
  12. Pusic A, Klassen A, Cano S. Breast-Q version 2.0© reconstruction module pre- and postoperative scales. Memorial Sloan Kettering Cancer Center and the University of British Columbia; 2017.
  13. Donnely E, Griffin MF, Butler PE. Robotic surgery: a novel approach for breast surgery and reconstruction. Plast Reconstr Surg Glob Open 2020;8:e2578. https://doi.org/10.1097/gox.0000000000002578