Robotic nipple-sparing mastectomy for the treatment of breast cancer: Feasibility and safety study

Abstract

Background: We previously devised and reported on an innovative surgical technique of robotic nipple-sparing mastectomy and immediate robotic breast reconstruction. Here we describe the outcome of the first 29 such consecutive procedures performed on breast cancer patients to assess feasibility, reproducibility and safety.

Methods: The following morbidity factors were tested: operation time, conversion rate to open technique, length of hospitalization, registration of complications for 1 year postoperatively and their characterization as either minor, major, or multiple, depending on clinical severity and treatment required.

Results: The total duration of the final robotic surgeries of our series was around 3 h, showing a very rapid learning curve. The conversion rate due to technical problems was 2 of the 29 procedures (6,9%). No major complications, including hematoma, seroma, skin or nipple-areola injury or necrosis or infection were observed for any case. Two patients had a small degree of blistering from internal electrocautery in the breast skin flap, both of which resolved in one week without any specific therapy. No systemic complications were observed.

Conclusion: The low conversion rate to open surgery, the rapid learning curve and the low rate of post-operative complications observed in this preliminary series lead us to endorse a prospective study aimed at evaluating patient satisfaction.

Keywords: Breast cancer; Breast reconstruction; Conservative mastectomy; Nipple-sparing mastectomy; Risk-reducing surgery; Robotic mastectomy.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Copyright © 2016 Elsevier Ltd. All rights reserved.

Figures

Figure 1

Learning Curve

Figure 2

Two-month postoperative outcome of the third patient. Comparison between RNSM for contralateral delayed risk reducing surgery (right side) and classical open technique (left side). It is still visible a small blistering from internal electrocautery in the upper quadrant.

Figure 3

Two-month postoperative outcome of the third patient. Lateral view. The 3 cm incision remain hidden in the axilla. It is still visible a small blistering from internal electrocautery in the upper quadrant.

Figure 4

14th Patient. Second post-opertive day of bilateral RNSM and IRBR.

Figure 5

14th Patient. One week of bilateral RNSM and IRBR. Lateral view.