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Updated: Jun 15, 2025
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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
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Learning curve for robot-assisted nipple-sparing mastectomy: A single institution experience
Sung Mi Jung1, Yeon Jin Kim2, Kyeong-Tae Lee3
1Division of Breast Surgery, Department of Surgery, Seoul Medical Center, Seoul, South Korea.
Summary
Robot-assisted nipple sparing mastectomy (RANSM) is feasible and acceptable. The learning curve for this procedure is short, with improved operation times and reduced complications after 21 cases.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Robot-assisted nipple sparing mastectomy (RANSM) offers potential advantages like hidden incisions and improved ergonomics.
- This study investigates the learning curve and feasibility of performing RANSM.
Purpose of the Study:
- To evaluate the learning curve associated with robot-assisted nipple sparing mastectomy (RANSM).
- To assess the technical feasibility and safety of RANSM with immediate breast reconstruction.
Main Methods:
- A retrospective analysis of 46 RANSM procedures performed by a single surgeon from July 2019 to June 2022.
- Cases were divided into early (1-21) and late (22-46) phases to analyze operative times (total, breast, docking, console) using CUSUM.
- Postoperative complications were graded using the Clavien-Dindo classification.
Main Results:
- Mean console time decreased significantly from 78.1 min in the early phase to 60.1 min in the late phase (p=0.011).
- The learning curve analysis indicated that 21 RANSM procedures were needed to optimize breast operation time.
- Two Clavien-Dindo grade III complications (4.3%) occurred in the early phase (infection, nipple ischemia), with none in the late phase.
Conclusions:
- Robot-assisted nipple sparing mastectomy demonstrates a short learning curve, with significant improvements in operative time after 21 cases.
- The procedure is technically feasible and acceptable, with a low rate of severe postoperative complications in the later phase.
- RANSM is a viable option for patients undergoing mastectomy with immediate breast reconstruction.
