Early experiences with robot-assisted prosthetic breast reconstruction

Area of Science:

• Surgical Oncology
• Robotic Surgery
• Breast Reconstruction

Background:

• Robotic surgery enhances procedures with multi-degree-of-freedom arms and 3D imaging.
• Nipple-sparing mastectomy with immediate reconstruction aims to reduce visible scarring.
• Minimally invasive techniques are increasingly sought for oncologic and reconstructive surgery.

Purpose of the Study:

• To evaluate the feasibility and outcomes of robot-assisted nipple-sparing mastectomy (R-NSM) combined with immediate robotic-assisted expander insertion.
• To assess the safety and efficacy of this combined approach in patients with invasive ductal carcinoma.
• To determine the potential for scar concealment and patient satisfaction.

Main Methods:

• Four patients with invasive ductal carcinoma underwent R-NSM and immediate robot-assisted expander insertion.
• Procedures were performed through a 6-cm incision along the anterior axillary line.
• Sentinel lymph node biopsy, mastectomy, pectoralis major elevation, ADM sling creation, and expander placement were robotically assisted.

Main Results:

• No major complications (hematoma, seroma, infection, capsular contracture, nipple-areolar necrosis) were observed in the four patients.
• The mean operative time for expander insertion was 1 hour and 20 minutes, decreasing with experience.
• The first patient achieved satisfactory 2-stage prosthetic reconstruction with unnoticeable scars and symmetry.

Conclusions:

• Robot-assisted nipple-sparing mastectomy with immediate expander insertion is a feasible surgical option.
• This technique effectively conceals surgical scars, enhancing patient satisfaction.
• Further studies are warranted to confirm long-term outcomes and expand its application.