Robotic-assisted skin sparing mastectomy and immediate reconstruction using latissimus dorsi flap a new effective and safe technique: A comparative study

Houvenaeghel, Gilles; Hajj, Houssein El; Schmitt, Andy; Cohen, Monique; Rua, Sandrine; Barrou, Julien; Lambaudie, Éric; Bannier, Marie

doi:10.1016/j.suronc.2020.09.022

Cited by 13 publications

(46 citation statements)

References 18 publications

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“…Even with the unstable operation time, an appreciable difference (of 140.3 min) in the mean operation times was observed between the NET and TET groups. As the surgeons became proficient in the NET and the operation time stabilized, the duration of the last 5 NET procedures became relatively stable (at 240.0 min) and was much shorter than that of the open surgery (at 401 min); however, previous research has shown that open surgery has a shorter operation time than RT ( 3 , 8 ) (as far as we are aware, no report has compared operation time between open surgery and ET).…”

Section: Discussionmentioning

confidence: 99%

“…There was no obvious difference in the levels of satisfaction between the NET and TET groups, which is probably because the same concealed incision was used in both groups. In most previous reports in which the ET or RT has been used to complete the NSM and LDMF reconstruction, more than one incisions ( 3 , 8 ) or less concealed incision should be required ( 30 ), even for partial BR with LDMF ( 9 , 14 ). In 2018, Lai et al reported inspiring results about the use of the RT for a single axillary incision-assisted NSM and IBR with LDMF, but the sample size was very small ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the RT has the disadvantages of high costs and a doubled docking time caused by changes in the patient's position (3,7). More importantly, according to the reported literature, if the ET or RT is used to complete both the NSM and LDMF dissection in 1 operation, multiple incisions or ports are required, and the resulting scars are poorly concealed (3,(8)(9)(10)(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Novel technique for endoscopic-assisted nipple-sparing mastectomy and immediate breast reconstruction with endoscopic-assisted latissimus dorsi muscle flap harvest through a single axillary incision: a retrospective cohort study of comparing endoscopic and open surgery

Wen¹,

Xie²,

Feng³

et al. 2022

Gland Surg

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Background: A novel endoscopic-assisted technique (NET) was created by our team for nipple-sparing mastectomy (NSM) and latissimus dorsi muscle flap (LDMF) reconstruction that enables the procedure to be conducted through a single axillary incision. The authors hypothesized that the NET has the advantages of the traditional ET (TET) and a reduced operation time. The purpose of this study is to compare the advantages and disadvantages of NET, TET and open surgery. Methods: A retrospective cohort study was performed on patients who underwent LDMF reconstruction after NSM using open surgery, the TET, or the NET between January 2013 and June 2021. The following outcomes were compared: the operation time, size of the LDMF, the complication rate, hospital length of stay, hospital costs, aesthetic results (the BREAST-Q questionnaire), and quality of life (QoL). The BREAST-Q questionnaire and QoL were underwent preoperatively and 1, 3, and 12 months postoperatively. Results: A total of 17 ETs (comprising 10 NETs and 7 TETs) and 28 open surgery procedures were identified and analyzed, the baseline characteristics were comparable in terms of age, BMI, tumor location, cup size, and disease stage of the three groups. The mean operation time of the NET group (395.8±176.0 min) in the exploration stage was shorter than that of the TET group (531.6±69.6 min) and equivalent to that of the open surgery group (400.9±67.3 min). The overall postoperative complication rates of the ET and open surgery groups were 35.3% and 60.7%, respectively (P=0.09). The aesthetic results in relation to patients' satisfaction with their breasts (P=0.001) and backs (P=0.001) were better in the ET group than the open surgery group beginning at 1 month postoperatively. The ET group had better psychosocial well-being beginning at 1 month postoperatively (P=0.002) and sexual well-being beginning at 3 months postoperatively (P<0.001) than the open surgery group.Conclusions: LDMF reconstruction after NSM using the ET is associated with lower complication rates, good aesthetic results, and a better QoL than open surgery procedures. The NET is a promising approach, a more convenient procedure, and has a shorter surgery time than TET, however, this conclusion needs to be further validated by RCT research with a larger sample size.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Novel technique for endoscopic-assisted nipple-sparing mastectomy and immediate breast reconstruction with endoscopic-assisted latissimus dorsi muscle flap harvest through a single axillary incision: a retrospective cohort study of comparing endoscopic and open surgery

Wen¹,

Xie²,

Feng³

et al. 2022

Gland Surg

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“…However, the risk of bleeding and haematoma was not significantly different when compared to traditional OT. Likewise, some cohort studies reported a higher seroma rate with MIS when compared to OT, while other series reported otherwise 4,7,41 …”

Section: Discussionmentioning

confidence: 99%

“…Several studies used insufflation 4,7,11,23,27,28,30–32,34,37,39 . In this review it was challenging to evaluate complications like subcutaneous emphysema, air embolism, hypothermia, and acid‐base imbalance.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive harvest of the latissimus dorsi flap for breast reconstruction: A systematic review

Escandón

Nazerali

Ciudad³

et al. 2022

Robotics Computer Surgery

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Background Poor cosmetic results with oncoplastic and implant‐based breast reconstruction have stimulated an interest in latissimus dorsi flap (LDF)‐based reconstruction. We reviewed the surgical techniques and outcomes of the LDF harvested with minimally invasive surgery. Methods A systematic search was conducted across PubMed‐MEDLINE, Web of Science, Scopus, and Ovid‐MEDLINE(R). Data on surgical outcomes were extracted. Results 31 articles were included reporting on 857 reconstructive procedures using a LDF harvested, 497 were endoscopic‐assisted LDF (EALDF) (58%) and 174 were robotic‐assisted LDF (RALDF) (20.3%). The average flap harvest time was 84.04‐min for EALDF and 106.14‐min for RALDF. With an EALDF, the incidence of haematoma, seroma, and wound dehiscence ranged between 0%–16.6%, 0%–48%, and 0%–6.2%, respectively. Using RALDF, the incidence of seroma was between 0%–26.1% and 0%–3.4% for haematoma. Conclusions While the indications for a LDF harvested with MIS are limited, its main advantage for breast reconstruction is the absence of the back scar.

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Robot‐assisted nipple‐sparing mastectomy and immediate breast reconstruction with gel implant and latissimus dorsi muscle flap: Our initial experience

Chen

Zhang

Beeraka

et al. 2023

Robotics Computer Surgery

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BackgroundThis study reports the preliminary results of da Vinci robot XI robot‐assisted nipple‐sparing mastectomy immediate breast reconstruction (R‐NSMIBR) with gel implant and latissimus dorsi muscle flap.MethodsA total of 15 patients who underwent R‐NSMIBR with gel implant and latissimus dorsi muscle flap surgery for breast cancer between September 2022 and November 2022 were evaluated.ResultsMean total operative time for R‐NSMIBR was 361.9 ± 77.0 min. As the learning curve increased, the robot arm docking time decreased rapidly from the initial 25–10 min. Average total blood loss was 27.8 ± 10.7 mL and posterior surgical margin positivity rate was 0%. Perioperative complications and local recurrences or deaths were not observed at a mean follow‐up of 3 ± 1 month 15 patients were satisfied with postoperative aesthetic results.ConclusionsR‐NSMIBR with a gel implant and latissimus dorsi muscle flap could be a new therapeutic option for breast reconstruction.

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Robotic-assisted skin sparing mastectomy and immediate reconstruction using latissimus dorsi flap a new effective and safe technique: A comparative study

Cited by 13 publications

References 18 publications

Novel technique for endoscopic-assisted nipple-sparing mastectomy and immediate breast reconstruction with endoscopic-assisted latissimus dorsi muscle flap harvest through a single axillary incision: a retrospective cohort study of comparing endoscopic and open surgery

Novel technique for endoscopic-assisted nipple-sparing mastectomy and immediate breast reconstruction with endoscopic-assisted latissimus dorsi muscle flap harvest through a single axillary incision: a retrospective cohort study of comparing endoscopic and open surgery

Minimally invasive harvest of the latissimus dorsi flap for breast reconstruction: A systematic review

Robot‐assisted nipple‐sparing mastectomy and immediate breast reconstruction with gel implant and latissimus dorsi muscle flap: Our initial experience

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