Robotic-assisted harvest of latissimus dorsi muscle flap for breast reconstruction: review of the literature.
Spyridon A VourtsisAnna PaspalaPanagis M LykoudisEleftherios SpartalisGerasimos TsourouflisDimitrios DimitroulisEmmanouil PikoulisNikolaos NikiteasPublished in: Journal of robotic surgery (2021)
Robotic-assisted surgery continues to gain ground over conventional surgical methods, due to reported better results regarding the aesthetic outcome and the decreased percentage of complications. Although latissimus dorsi flap harvesting for breast reconstruction has been already used for several years, a plethora of serious complications has been reported. Recently, minimally invasive surgical approaches, such as robotic-assisted technique, have been suggested with conflicting outcomes to overcome technical difficulties. Therefore, the literature review was conducted regarding robotic-assisted harvesting of the latissimus dorsi flap for breast reconstruction. A narrative review of the contemporary literature was performed in the PubMed database for the use of robotic-assisted surgery of latissimus dorsi muscle flap harvesting for breast reconstruction. Appropriate search terms were used, and specific inclusion and exclusion criteria were applied. Five studies met the inclusion criteria. A total of 32 cases of robotically assisted harvesting of pedicled latissimus dorsi muscle flap for implant-based breast reconstruction have been identified. All flaps were successfully harvested without converting in the traditional open procedure. There were no significant postoperative complications, expect from few cases of postoperative seromas, which were conservatively managed. Additionally, all patients were satisfied with their postoperative cosmetic outcome. The robotic-assisted harvesting technique of the latissimus dorsi flap for breast reconstruction is safe and comparable to the conventional methods. Reduced hospital stays and superior aesthetic outcome are the main advantages, while total cost and the difficulty of reaching the learning curve plateau are the main concerns regarding this modern and minimally invasive surgical approach.
Keyphrases
- breast reconstruction
- minimally invasive
- energy transfer
- skeletal muscle
- robot assisted
- patients undergoing
- systematic review
- end stage renal disease
- coronary artery bypass
- prognostic factors
- ejection fraction
- emergency department
- case report
- risk factors
- newly diagnosed
- type diabetes
- adipose tissue
- coronary artery disease
- soft tissue
- electronic health record