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Robot-assisted Axillary Lymph Node Dissection for Axillary Lymph Node Metastasis in Breast Cancer.

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Robotic-assisted axillary lymph node dissection (R-ALND) offers a precise, minimally invasive approach for breast cancer patients. This technique shows promise in reducing surgical complications compared to traditional methods.

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Area of Science:

  • Surgical Oncology
  • Minimally Invasive Surgery
  • Robotic Surgery

Background:

  • Axillary lymph node dissection is critical for staging breast cancer, particularly N2-3 disease.
  • Conventional open surgery risks intercostobrachial nerve injury, causing pain and reduced quality of life.
  • Robotic-assisted axillary lymph node dissection (R-ALND) offers potential for enhanced precision and fewer complications.

Purpose of the Study:

  • To evaluate the safety, efficacy, and outcomes of robotic-assisted axillary lymph node dissection (R-ALND) in breast cancer patients.
  • To analyze the technical advantages and perioperative complications associated with R-ALND.
  • To assess early recurrence rates following R-ALND.

Main Methods:

  • Retrospective analysis of breast cancer patients who underwent R-ALND between March 2024 and March 2025.
  • Utilized the da Vinci surgical system with a systematic 'bottom-up, back-to-front' dissection approach.
  • Focused on preserving critical structures like the intercostobrachial nerve and blood vessels.

Main Results:

  • Mean operative time was 48.16 minutes with minimal blood loss (median 3.00 mL).
  • A median of 18 lymph nodes were dissected, with a median of 1 metastatic node identified.
  • No perioperative complications (hemorrhage, infection, seroma, etc.) or recurrence were observed during the mean 8.70-month follow-up.

Conclusions:

  • R-ALND is a safe and precise method for axillary lymph node dissection in breast cancer.
  • The technique leverages 3D visualization and improved instrument maneuverability to minimize complications.
  • Further research is needed to validate long-term survival benefits of R-ALND.