Gasless Robot-Assisted Nipple-Sparing Mastectomy: A Case Report

Hyung Seok Park, Joo Heung Kim, Dong Won Lee, Seung Yong Song, Seho Park, Seung Il Kim, Dae Hyun Ryu, Young Up Cho, Hyung Seok Park, Joo Heung Kim, Dong Won Lee, Seung Yong Song, Seho Park, Seung Il Kim, Dae Hyun Ryu, Young Up Cho

Abstract

Robotic surgical systems enhance surgical accuracy and efficiency by applying advanced technologies such as artificial arm joints to provide higher degrees of freedom of movement and high-quality three-dimensional images. However, the application of robotic surgical systems to breast surgery has not been widely attempted. The robotic system would improve cosmesis by enabling surgery using a single small incision. We report the first case of a gasless robot-assisted nipple-sparing mastectomy and immediate reconstruction in a patient with early breast cancer.

Keywords: Breast neoplasms; Mastectomy; Robotic surgical procedures.

Conflict of interest statement

CONFLICT OF INTEREST: The authors declare that they have no competing interests.

Figures

Figure 1. Patient position. (A) A picture…
Figure 1. Patient position. (A) A picture of patient position. (B) A schematic illustration of patient position. The ipsilateral arm was straightened to the head and fixed to the arm board.
Figure 2. Modified Chung's retractor.
Figure 2. Modified Chung's retractor.
Figure 3. Docking status. (A) Fenestrated bipolar…
Figure 3. Docking status. (A) Fenestrated bipolar forceps and permanent cautery spatula were placed on both lateral sides of the scope. (B) ProGrasp forceps were placed on the left side of the spatula to retract and counter-retract breast parenchyma.

References

    1. Tokin C, Weiss A, Wang-Rodriguez J, Blair SL. Oncologic safety of skin-sparing and nipple-sparing mastectomy: a discussion and review of the literature. Int J Surg Oncol. 2012;2012:921821.
    1. Laronga C, Smith P. Nipple-sparing mastectomy: an oncologic and cosmetic perspective. Surg Oncol Clin N Am. 2014;23:549–566.
    1. Munhoz AM, Montag E, Filassi JR, Gemperli R. Immediate nipple-areola-sparing mastectomy reconstruction: an update on oncological and reconstruction techniques. World J Clin Oncol. 2014;5:478–494.
    1. Peters BS, Armijo PR, Krause C, Choudhury SA, Oleynikov D. Review of emerging surgical robotic technology. Surg Endosc. 2018;32:1636–1655.
    1. Toesca A, Peradze N, Manconi A, Galimberti V, Intra M, Colleoni M, et al. Robotic nipple-sparing mastectomy for the treatment of breast cancer: feasibility and safety study. Breast. 2017;31:51–56.
    1. Sarfati B, Honart JF, Leymarie N, Rimareix F, Al Khashnam H, Kolb F. Robotic da Vinci Xi-assisted nipple-sparing mastectomy: first clinical report. Breast J. 2018;24:373–376.
    1. Lee J, Chung WY. Robotic surgery for thyroid disease. Eur Thyroid J. 2013;2:93–101.
    1. Toesca A, Peradze N, Galimberti V, Manconi A, Intra M, Gentilini O, et al. Robotic nipple-sparing mastectomy and immediate breast reconstruction with implant: first report of surgical technique. Ann Surg. 2017;266:e28–e30.
    1. Gottlieb A, Sprung J, Zheng XM, Gagner M. Massive subcutaneous emphysema and severe hypercarbia in a patient during endoscopic transcervical parathyroidectomy using carbon dioxide insufflation. Anesth Analg. 1997;84:1154–1156.
    1. Yu J, Al Mushawah F, Taylor ME, Cyr AE, Gillanders WE, Aft RL, et al. Compromised margins following mastectomy for stage I-III invasive breast cancer. J Surg Res. 2012;177:102–108.
    1. Cao D, Tsangaris TN, Kouprina N, Wu LS, Balch CM, Vang R, et al. The superficial margin of the skin-sparing mastectomy for breast carcinoma: factors predicting involvement and efficacy of additional margin sampling. Ann Surg Oncol. 2008;15:1330–1340.
    1. Childs SK, Chen YH, Duggan MM, Golshan M, Pochebit S, Wong JS, et al. Surgical margins and the risk of local-regional recurrence after mastectomy without radiation therapy. Int J Radiat Oncol Biol Phys. 2012;84:1133–1138.
    1. Bryan ML, D'Agostino RB, Brown DR, Howard-McNatt MM. Is postmastectomy radiation therapy indicated in patients with close or positive margins? Adv Breast Cancer Res. 2016;5:66–73.
    1. Childs SK, Chen YH, Duggan MM, Golshan M, Pochebit S, Punglia RS, et al. Impact of margin status on local recurrence after mastectomy for ductal carcinoma in situ. Int J Radiat Oncol Biol Phys. 2013;85:948–952.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe