Robot-assisted Pelvic Reconstruction Using Rectus Abdominis Flap: Efficiency Evaluation of Adding a Third Surgeon

Area of Science:

• Surgical Reconstruction
• Minimally Invasive Surgery
• Pelvic Floor Disorders

Background:

• The rectus abdominis flap is a standard for pelvic reconstruction.
• Robotic techniques aim to decrease morbidity associated with open surgery.
• Previous studies compared open vs. robotic approaches; current technique has evolved.

Purpose of the Study:

• To evaluate the outcomes of robotic rectus harvest for perineal reconstruction.
• To compare 3-surgeon versus 2-surgeon reconstruction teams.
• To assess the feasibility of plastic surgeons performing the entire procedure independently.

Main Methods:

• Retrospective review of patients undergoing robotic rectus harvest (2018-2023).
• Data stratified by 3-surgeon vs. 2-surgeon reconstruction teams.
• Collected data: demographics, risk factors, perioperative, and postoperative outcomes.

Main Results:

• 14 patients included: 8 in 3-surgeon, 6 in 2-surgeon cohort.
• No significant differences in operative time, console time, or length of stay.
• Overall complication rates were similar between groups.

Conclusions:

• Plastic surgeons can perform robotic rectus harvest, repair, and flap inset independently.
• The addition of a general surgeon may not be necessary.
• This approach may streamline pelvic reconstruction procedures.