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Advancing DIEP Flap Surgery: Robotic-Assisted Harvest Reduces Pain and Narcotic Use
Chloe V McCreery1, Amy Liu2, Peter Deptula1
1John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI 96813, USA.
Journal of Clinical Medicine
|August 14, 2025
Summary
Robotic deep inferior epigastric artery perforator (DIEP) flap surgery in breast reconstruction shows reduced postoperative pain, narcotic use, and antiemetic requirements compared to traditional free flaps. This technique preserves the rectus abdominis muscle, offering improved patient outcomes.
Area of Science:
- Plastic Surgery
- Surgical Oncology
- Reconstructive Surgery
Background:
- Robotic deep inferior epigastric artery perforator (DIEP) flap surgery is an advanced technique for autologous breast reconstruction.
- It aims to preserve rectus abdominis muscle integrity while employing robotic assistance for flap harvesting.
- This method is explored for its potential to improve patient recovery and surgical outcomes.
Purpose of the Study:
- To assess the postoperative outcomes of robotic DIEP flap breast reconstruction.
- Key metrics include postoperative pain, narcotic usage, and antiemetic requirements.
- Comparison with traditional abdominal-based free flap reconstruction methods.
Main Methods:
- Retrospective analysis of patients undergoing robotic DIEP flap breast reconstruction (March 2024 - March 2025).
- Data collected: pain scores, oral morphine equivalents (OME), antiemetic use, and complications.
- Outcomes compared against a control group of 40 patients with traditional free flap reconstruction.
Main Results:
- 14 patients (24 breasts) underwent robotic DIEP flap reconstruction; average age 56.5.
- No unplanned returns to OR or flap failures observed.
- Significantly lower narcotic and antiemetic dosages, and decreased pain scores (POD2, POD3) compared to the control group.
Conclusions:
- Robotic DIEP flap reconstruction demonstrates advantages over traditional abdominal free flaps.
- The technique appears to reduce flap failure and complications.
- Improved postoperative pain management and reduced medication requirements are key benefits.
