Use of Robotic Surgery in Plastic and Reconstructive Surgery: A Narrative Review

Area of Science:

• Surgical Technology
• Plastic and Reconstructive Surgery
• Minimally Invasive Surgery

Background:

• Robotic systems offer superior precision, dexterity, and visualization crucial for complex plastic surgery.
• While established in other specialties, robotic applications in plastic surgery are not yet widely explored.
• This review focuses on clinical outcomes of robotic systems in plastic and reconstructive surgery.

Purpose of the Study:

• To review the current applications and clinical outcomes of robotic systems in plastic and reconstructive surgery.
• To identify areas where robotic technology can enhance surgical precision and patient results.
• To assess the potential of robotics in overcoming existing challenges in plastic surgery.

Main Methods:

• A comprehensive literature search was performed across PubMed, Embase, Scopus, and Web of Science.
• Included studies focused on clinical outcomes and biomimetic innovations in robotic surgery for plastic and reconstructive procedures (1980-2024).
• Excluded non-English, cadaver-based, and animal studies; data extraction and analysis were conducted using Covidence.

Main Results:

• Twenty-nine studies reported on robotic use in breast reconstruction, microsurgery, and craniofacial procedures.
• Robotic platforms (e.g., Da Vinci, Symani) provide motion scaling and tremor elimination.
• Nipple-sparing mastectomies saw reduced skin necrosis (8% to 2%); DIEP flaps had smaller incisions and faster recovery; microsurgery achieved 100% vessel patency (<0.3 mm).

Conclusions:

• Robotic systems demonstrate significant promise in plastic and reconstructive surgery, especially for nipple-sparing mastectomies.
• Robotics can potentially mitigate surgeon fatigue and improve outcomes in complex procedures.
• Barriers to adoption include extended operating times, high costs, and limited haptic feedback.