Robot-assisted radial forearm free flap harvesting: a propensity score-matched case–control study

Abstract

Although some surgeons prefer anterolateral thigh and latissimus dorsi ap for soft tissue reconstruction in head and neck area because it minimizes donor site complications, radial forearm ap remains the workhorse for soft tissue reconstruction due to its reliability. To reduce donor site morbidity, the authors developed a novel technique for radial forearm ap harvesting using a robotic device. 42 radial forearm free ap reconstruction cases were studied, consisting of 31 conventional and 11 robotassisted cases. 1:1 propensity score matching was done according to age, sex, previous and postoperative radiation therapy history and method used for vein anastomosis.There were no signi cant difference was in ap outcome, which was 100% vitality in the robot-assisted group and 90.9% vitality in the conventional group. The robot-assisted group showed signi cantly longer mean harvesting time than did the conventional group, being 107.2 minutes and 67.0 minutes respectively.Robot-assisted radial forearm ap harvesting can reduce donor site complications by minimizing incision. When more surgical experience is gained under appropriate case selection, we expect our robotassisted method will yield a harvesting time similar to that of the conventional method and thus become more reliable and feasible.

Robotic-assisted free flap harvesting for diverse soft tissue reconstruction: a PRISMA scoping review of clinical outcomes over the last decade

“…In postoperative follow-up, the robot cases had better and superior aesthetic outcomes due to reduced linear scarring. However, the robot-assisted harvesting took significantly longer time than the conventional group 16 .…”

“…2), among which one(1.1 %) 14 site haematoma 18 1 (1.1 %), donor site morbidity i.e abdominal hernias or wound healing 15 in 1(1.1 %) and unspecified surgical site occurrences (including breast wound dehiscence, infection, skin flap necrosis, fat necrosis, haematoma and seroma)20 5(5.8%), moreover, complication status was not reported for 41 patients. 16,22,23 Analysis of complications by flap type showed that all these patients had DIEP flap reconstruction, therefore, complication rate in DIEP flap, with denominator 120, was 15(12.5%).…”