Robotic-Assisted Latissimus Dorsi Flap Harvest in Partial Breast Reconstruction: Comparison With Endoscopic and Conventional Approaches.

Abstract

Latissimus dorsi muscle flaps are widely used in breast reconstruction, for which several methods have been introduced. To compare the outcomes of robotic-assisted breast reconstruction using latissimus dorsi muscle flap following partial mastectomy with the outcomes of conventional and endoscopic-assisted techniques. In this prospective single-institutional study, Korean females diagnosed with breast cancer who underwent partial mastectomy and breast reconstruction using a latissimus dorsi flap from March 2020 to December 2021 were included. The outcomes of surgery, as well as patient satisfaction, were compared between the conventional, endoscopic-assisted, and robotic-assisted techniques. In total, 57 patients were included in this study, among which 20 underwent conventional reconstruction, and 17 and 20 patients underwent endoscopic and robotic surgery, respectively. There was no statistically significant difference between the three methods in respect of postoperative opioid analgesic dosage (p = 0.459), hospitalization period (p = 0.225), and the average total amount of donor site drainage during hospitalization (p = 0.175). In respect of patient satisfaction after surgery, especially the donor site scar, the conventional method showed a significantly lower score compared with the other 2 techniques. Robotic-assisted breast reconstruction using a latissimus dorsi muscle flap after partial mastectomy showed higher patient satisfaction than that in the conventional open method. Considering that robotic surgery is more convenient than the endoscopic technique, it is potentially a good alternative to conventional open or endoscopic surgery.