Novel technique for laparoscopic harvesting of latissimus dorsi flap with prosthesis implantation for breast reconstruction

Xu, Shuman; Tang, Peng; Chen, Xianchun; Yang, Xi; Pan, Qinwen; Gui, Yu; Chen, Li

doi:10.1097/md.0000000000005428

Cited by 17 publications

(28 citation statements)

References 16 publications

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“…Endoscopic non-robotic LDFR was reported in several studies [4][5][6][7][8], and in 2007, Missana et al reported a study including 52 patients [4] and more recently by others with smaller series [6][7][8]. Nakajima et al [8] reported a study with 168 LDF video-assisted reconstructions but only for reconstruction after partial mastectomy.…”

Section: Discussionmentioning

confidence: 99%

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Skin sparing mastectomy and robotic latissimus dorsi-flap reconstruction through a single incision

et al. 2019

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Background: Robotic latissimus dorsi-flap reconstruction (RLDFR) after skin-sparing mastectomy (SSM) for breast cancer (BC) has been performed through a single nipple incision. We report results of SSM with RLDFR, mainly with analysis of feasibility, morbidity, indications, and technique standardization. Methods: We determined characteristics of patients, previous treatment of BC, and type of reconstruction. Surgical technique, duration of surgery, and complication rate were reported according to three successive periods: P1-3. Results: Forty RLDFR, with breast implant for 16 patients, with previous breast radiotherapy in 30% had been performed. In logistic regression, factors significantly associated with duration of surgery ≥ 300 min were P2 (OR 0.024, p = 0.004) and P3 (OR 0.012, p = 0.004) versus P1. The median mastectomy weight was 330 g and 460 g for BMI < and ≥ 23.5 (p = 0.025). Length of hospitalization was 4 days. Total complication rate was 20% (8/40): seven breast complications (four re-operations) and one RLDF complication with re-operation. Periods were significantly predictive of complications (p = 0.045). Conclusion: SSM with RLDFR is feasible, safe, and reproducible. We reported a decrease of duration of surgery, length of post-operative hospitalization, and complication rate.

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Section: Discussionmentioning

confidence: 99%

“…Development of robotic surgery since several years was very important for prostatic cancer, gynecologic cancer, colo-rectal cancer, and thoracic and thyroid surgery [1][2][3]. Endoscopic non-robotic latissimus dorsi-flap breast reconstruction (LDFR) has been reported in several studies [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Skin sparing mastectomy and robotic latissimus dorsi-flap reconstruction through a single incision

et al. 2019

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“…For instance, in our institution, we performed endoscopic harvesting of latissimus dorsi flap with prosthesis implantation for immediate breast reconstruction after nipple-sparing mastectomy in 2 patients with breast cancer who wished to avoid a long scar on the back. Both patients were satisfied with the esthetic results of the procedure using only 3 small trocar ports instead of a long visible scar on the back [34].…”

Section: Discussionmentioning

confidence: 99%

Less micrometastatic risk related to circulating tumor cells after endoscopic breast cancer surgery compared to open surgery

Yan

Yang

et al. 2019

BMC Cancer

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BackgroundIncrease of circulating tumor cells (CTCs) has been found after surgery for various carcinomas but not confirmed for breast cancer, and whether endoscopic surgery confers identical effect to CTCs as open surgery did is not clear. The present study aimed to investigate whether CTCs increase after surgery and whether there is a difference between open surgery and endoscopic surgery.MethodsPre- and postoperative peripheral blood (5 mL) obtained from 110 female patients with operable breast cancer (53 underwent endoscopic surgery, 57 underwent open radical mastectomy). Quantitative real-time reverse transcription-PCR was done to detect cytokeratin 19 mRNA-positive CTC. CTC detection rate, cell number and the increase after surgery (named micrometastasis) were compared between the two groups.ResultsIn the open group, CTC positive rate before and after surgery were 22.81 and 33.33%; median CTC number before and after surgery were 0.21 and 0.43 and 17 patients (29.82%) had increased micrometastatic risk. In the endoscopic group, CTC positive rate before and after surgery were 24.53 and 28.30%; median CTC number before and after surgery were 0.27 and 0.36, and 8 patients (15.09%) had increased micrometastatic risk. There was a suggestive higher postoperative CTC detection rate and CTC number and a significant increased postoperation micrometastatic risk was observed in the open group compared to the endoscopic group (OR = 3.19, 95%CI: 1.05–9.65) after adjustment for clinicopathologic characteristics.DiscussionCTC tends to increase in breast cancer patients after surgery, and the micrometastatic risk was higher for open surgery compared to endoscopic surgery.Trial registrationThis study was prospectively registered at Chinese Clinical Trial Register (ChiCTR-OCH-10000859, 24 April 2010).

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“…Although this method is designed to cover the surgical scar on the bra line at the back, the inevitable presence of long scars remains a disadvantage. To compensate for this drawback, a method of transferring and applying an LD muscle flap to the mid-axillary line has been developed [ 36 37 ]. Using the latest devices (endoscopy-assisted or robotic-assisted methods), total breast reconstruction is possible by transferring only the LD muscle flap through a smaller incision using the one-port incision method to approach the mid-axillary line ( Figure 9 ).…”

Section: Breast Reconstruction After “Aesthetic Scar-less” Nipple-spamentioning

confidence: 99%

Aesthetic Scar-Less Mastectomy and Breast Reconstruction

Yang

Lee

et al. 2021

J Breast Cancer

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Surgical approaches in breast cancer have been changing to ensure both oncologic safety and cosmetic results. Although the concept of “oncoplastic breast surgery” has been accepted for decades, breast and plastic surgeons have been striving to develop more advanced surgical skills that ensure non-inferior oncologic outcomes with better cosmetic outcomes. Endoscopic or robotic devices, which are currently available only for chest or abdominal surgeries, could be used for breast surgery to ensure better cosmetic outcomes. The authors refer to this surgical concept as “aesthetic scar-less breast surgery and reconstruction,” a term that encompasses the consequential concepts rather than naming it with simple technical words such as endoscopy-assisted or robot-assisted surgery. The “scar-less” term simply means leaving less of a scar, and better results can be expected by designing incisions on invisible areas. Herein, we summarize our experiences with various techniques of “aesthetic scar-less” surgery and review the existing literature on this topic.

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Novel technique for laparoscopic harvesting of latissimus dorsi flap with prosthesis implantation for breast reconstruction

Abstract: Supplemental Digital Content is available in the text

Cited by 17 publications

References 16 publications

Skin sparing mastectomy and robotic latissimus dorsi-flap reconstruction through a single incision

Skin sparing mastectomy and robotic latissimus dorsi-flap reconstruction through a single incision

Less micrometastatic risk related to circulating tumor cells after endoscopic breast cancer surgery compared to open surgery

Aesthetic Scar-Less Mastectomy and Breast Reconstruction

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