Single-port robot-assisted prosthetic breast reconstruction with the da Vinci SP Surgical System: first clinical report

Oh Young Joo, Seung Yong Song, Hyung Seok Park, Tai Suk Roh, Oh Young Joo, Seung Yong Song, Hyung Seok Park, Tai Suk Roh

Abstract

Robot-assisted nipple-sparing mastectomy with immediate reconstruction is currently performed in an attempt to seek smaller and indistinct incisions. Robotic surgery system has been evolving under the concept of minimal invasive technique which is a recent trend in surgery. One of the latest version is the da Vinci SP Surgical System (Intuitive Surgical). In this report, we will share our experiences. Two patients underwent robot-assisted nipple-sparing mastectomy, each followed by immediate robot-assisted expander insertion and prepectoral direct-to-implant breast reconstruction, respectively. There was no open conversion or major postoperative complication. One patient experienced mild infection, which was resolved by intravenous antibiotic treatment. Simple docking process, multi-joint instruments, and third-arm functionality are among the new surgical system's advantages. The present cases suggest that robot-assisted nipple-sparing mastectomy with immediate reconstruction using the da Vinci SP Surgical System is feasible and safe. The promising features and potential application of da Vinci SP in breast reconstruction need further study.

Keywords: Da Vinci SP; Mammaplasty; Robotic surgery.

Conflict of interest statement

Conflict of interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Incision on axilla. Four centimeters incision on axilla is noted. Robot-assisted nipple-sparing mastectomy and sentinel lymph node biopsy was performed by our institute’s oncologic surgeon.
Fig. 2.
Fig. 2.
ADM coverage for prepectoral DTI reconstruction. (A) Anteroposterior view. (B) Posteroanterior view. One sheet of ADM was designed and sewn to fully cover the implant. ADM, acellular dermal matrix; DTI, direct-to-implant.
Fig. 3.
Fig. 3.
ADM-wrapped implant insertion through funnel kit. ADM, acellular dermal matrix.
Fig. 4.
Fig. 4.
Acellular dermal matrix sling fixation.
Fig. 5.
Fig. 5.
Preoperative and postoperative frontal views (case 1). Preoperative and at 1 month postoperative.
Fig. 6.
Fig. 6.
Preoperative and postoperative frontal views (case 2). Preoperative and at 1 month postoperative, with 460 cc inflated tissue expander.
Fig. 7.
Fig. 7.
Postoperative scar after 1 year.

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Source: PubMed

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