Robotic harvest of the rectus abdominis muscle: principles and clinical applications

Harvest of the rectus abdominis muscle requires an abdominal incision as well as violation of the anterior rectus sheath, creating the potential for significant surgical-site morbidity (bulges, hernias, infections, seromas). Laparoscopic or endoscopic techniques, although feasible, have not become popular among plastic surgeons due to multiple technical shortcomings. Robotic surgery on the other hand has an easier learning curve, enhanced precision, tremor elimination, motion scaling, high resolution, three-dimensional optics and an intuitive interface. As a result of these advantages, robotic surgery has permeated into the plastic surgery specialty, assuming a role in the harvest of the latissimus dorsi muscle flap and other reconstructive procedures. In this review, the authors discuss its applicability in the harvest of the rectus abdominis muscle.