Abstract P4-13-08: Robotical-assisted laparoscopy for latissimus dorsi flap harvesting in breast reconstruction : A 23 consecutive cases report

Abstract

Abstract Background : Latissimus dorsi (LD) flap is a classic and usual procedure for immediate or secondary breast reconstruction with good results and poor complication rate. The principal issue is the long and often painful dorsal scar. The feasibility of laparoscopic LD flap harvesting and more recently robotically-assisted laparoscopy were described in short series. We report in this article the largest series of robotically-assisted laparoscopic LD flap harvesting. We describe its feasibility and the immediate and early post operative outcomes. Material et methods : Between January 27th and December 21th of 2016, we performed 23 robotically-assisted laparoscopic LD flap harvestings in immediate and secondary breast reconstruction. Every patient was systematically sent for an evaluation of aesthetic result, pain and satisfaction on the second, the sixth and the twelth month. Results : 78,3% of surgeries were realized for infiltrative breast cancer.17 (73,9%) LD flaps were harvested in immediate reconstruction after nipple or skin sparing mastectomies (NSM -34,8%-or SSM -43,5%). The global mean operative time was 360,1 minutes, including bilateral and robotically-assisted mastectomies. The mean hospital stay duration was 5 days (2-8 days). We described one failure for secondary LD flap reconstruction (infection). The other cases resulted in successful reconstructions without heavy complications. Discussion :Our series is the largest reported. It confirms the feasibility of a robotically-assisted procedure in breast reconstruction with LD flaps. Our study describes a reliable option for LD flap breast reconstruction without any additional scar. Some procedures were combined in selected patients with a robotic NSM with a single axillar incision. Citation Format: Houvenaeghel G, Rua S, Franké O, Cohen M, Lambaudie E. Robotical-assisted laparoscopy for latissimus dorsi flap harvesting in breast reconstruction : A 23 consecutive cases report [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-13-08.