Conventional versus Robot-assisted Immediate Breast Reconstruction: Reconstructive Outcome and Patient-reported Outcome Measures (PROMs).

Abstract

This study compared conventional and robot-assisted mastectomy and breast reconstruction. To the best of our knowledge, this study is the first to report the results of robot-assisted mastectomy and breast reconstruction as well as a comparison of patient-reported outcomes. A retrospective study included 473 breasts of 423 patients who underwent conventional mastectomy and breast reconstruction and 164 breasts of 153 patients who underwent robot-assisted mastectomy and breast reconstruction from July 2019 to October 2021. Demographic and oncologic data, reconstructive outcomes, and patient-reported outcomes (BREAST-Q) were evaluated. The results of implant-based and autologous breast reconstruction were separately evaluated. Skin necrosis requiring surgical debridement occurred significantly more frequently in the conventional group (8.0%) than in the robot-assisted group (2.0%) in implant-based reconstruction (p=0.035). At 6-12 months, robot-assisted breast reconstruction showed a higher sexual wellbeing score for implant-based reconstruction and a higher physical wellbeing score for autologous breast reconstruction than conventional breast reconstruction according to the BREAST-Q questionnaire. Robot-assisted mastectomy and breast reconstruction was associated with less skin necrosis and better patient-reported outcomes (sexual wellbeing for implant-based reconstruction and physical wellbeing for autologous breast reconstruction) than the conventional option. Robotic surgery could be a good option for mastectomy and breast reconstruction.