Early experiences with robot-assisted prosthetic breast reconstruction

• Published in: Archives of plastic surgery Vol. 46; no. 1; pp. 79 - 83
• Main Authors: Ahn, Sung Jae, Song, Seung Yong, Park, Hyung Seok, Park, Se Ho, Lew, Dae Hyun, Roh, Tai Suk, Lee, Dong Won
• Format: Journal Article
• Language: English
• Published: 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA Thieme Medical Publishers, Inc 01.01.2019; Korean Society of Plastic and Reconstructive Surgeons; 대한성형외과학회
• Subjects: breast implants; Case Report; mammaplasty; robotic surgical procedures; tissue expansion devices; 성형외과학; Tissue expansion devices; Mammaplasty; Robotic surgical procedures; Breast implants
• ISSN: 2234-6163; 2234-6171; 2234-6171
• DOI: 10.5999/aps.2018.00052

Robotic surgery facilitates surgical procedures by employing flexible arms with multiple degrees of freedom and providing high-quality 3-dimensional imaging. Robot-assisted nipplesparing mastectomy with immediate reconstruction is currently performed to avoid breast scars. Four patients with invasive ductal carcinoma underwent robot-assisted nipple-sparing mastectomy and immediate robot-assisted expander insertion. Through a 6-cm incision along the anterior axillary line, sentinel lymph node biopsy and nipple-sparing mastectomy were performed by oncologic surgeons. The pectoralis major muscle was elevated, an acellular dermal matrix (ADM) sling was created with robotic assistance, and an expander was inserted into the subpectoral, sub-ADM pocket. No patients had major complications such as hematoma, seroma, infection, capsular contracture, or nipple-areolar necrosis. The mean operation time for expander insertion was 1 hour and 20 minutes, and it became shorter with more experience. The first patient completed 2-stage prosthetic reconstruction and was highly satisfied with the unnoticeable scar and symmetric reconstruction. We describe several cases of immediate robot-assisted prosthetic breast reconstruction. This procedure is a feasible surgical option for patients who want to conceal surgical scars.