Robot-assisted breast reconstruction using the prepectoral anterior tenting method

Area of Science:

• Surgical Oncology
• Plastic and Reconstructive Surgery
• Robotic Surgery

Background:

• Prepectoral prosthetic breast reconstruction using acellular dermal matrix (ADM) is increasingly popular.
• Robotic assistance offers potential benefits for enhancing surgical procedures.

Purpose of the Study:

• To introduce and evaluate robot-assisted prosthetic breast reconstruction utilizing the anterior tenting method.
• To assess the feasibility and outcomes of this novel surgical approach.

Main Methods:

• A prospective study included 16 patients undergoing direct-to-implant (DTI) reconstruction with ADM support.
• The da Vinci Xi robotic system was employed for mastectomies and prepectoral anterior tenting reconstruction.
• Procedures were performed between July 2019 and April 2020.

Main Results:

• 14 patients had nipple-sparing mastectomies, and 2 had skin-sparing mastectomies.
• Average operating times were 194.7 minutes for the oncology team and 80.8 minutes for the plastic surgery team.
• Minor complications occurred in 2 patients, with average postoperative drainage of 943.6 mL.

Conclusions:

• Robot-assisted surgery enables smaller incisions (approx. 4.5 cm) and improved access to difficult-to-reach areas.
• Enhanced visualization facilitates precise creation of the implant pocket under ADM.
• The technique supports inframammary fold restoration and effective control of potential bleeding.