Robotic Surgery: A Novel Approach for Breast Surgery and Reconstruction
Background:. Breast cancer is the most prevalent cancer and second leading cause of cancer-related deaths in both the US and UK female population, a prominent cause of morbidity and cost to both health services. All surgically fit patients are offered breast reconstruction following the initial surg...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2020-01-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002578 |
| _version_ | 1828762733797965824 |
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| author | Edward Donnely, MBBS, BSc (Hons), MRCS Michelle F. Griffin, MBChB, MRes MSc, MRCS, PhD Peter E. Butler, MD, FRCSI, FRCS (Plast) |
| author_facet | Edward Donnely, MBBS, BSc (Hons), MRCS Michelle F. Griffin, MBChB, MRes MSc, MRCS, PhD Peter E. Butler, MD, FRCSI, FRCS (Plast) |
| author_sort | Edward Donnely, MBBS, BSc (Hons), MRCS |
| collection | DOAJ |
| description | Background:. Breast cancer is the most prevalent cancer and second leading cause of cancer-related deaths in both the US and UK female population, a prominent cause of morbidity and cost to both health services. All surgically fit patients are offered breast reconstruction following the initial surgery, and this is traditionally an open approach: either implant-based or an autologous tissue flap. Both lead to scarring that is difficult to conceal. This paper aims to evaluate the novel minimally invasive technique of robotic-assisted surgery.
Methods:. A systematic review was conducted using Medline (OvidSP) and Embase (OvidSP) to evaluate the current application of robotic-assisted surgery in breast surgery and reconstruction.
Results:. Twenty-one articles were identified and discussed, composing of level 4 and 5 evidence comparing different surgeons' experiences, techniques, and outcomes. To date, the robotic system has been utilized to harvest the latissimus dorsi muscle for use as a tissue flap (total harvest time of 92 minutes), to perform nipple-sparing mastectomy with immediate breast reconstruction (total operation time 85 minutes) and lately to harvest a deep inferior epigastric perforator flap via an intraabdominal approach.
Conclusions:. Robotic-assisted surgery can successfully and reproducibly perform a nipple-sparing mastectomy with breast reconstruction. It can minimize the size of scarring and is superior to the laparoscopic technique, with improved 3-dimensional visualization, dexterity, and range of motion able to guide around the curvature of the breast. The main limiting factors are the lack of the US Food and Drug Administration approval, cost of the robot, and specialized skills required. |
| first_indexed | 2024-12-11T01:48:49Z |
| format | Article |
| id | doaj.art-7c44136b8eec4361beb1ca5946ca96a2 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-11T01:48:49Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-7c44136b8eec4361beb1ca5946ca96a22022-12-22T01:24:48ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742020-01-0181e257810.1097/GOX.0000000000002578202001000-00003Robotic Surgery: A Novel Approach for Breast Surgery and ReconstructionEdward Donnely, MBBS, BSc (Hons), MRCS0Michelle F. Griffin, MBChB, MRes MSc, MRCS, PhD1Peter E. Butler, MD, FRCSI, FRCS (Plast)2From the Division of Surgery and Interventional Science, University College London, Royal Free Hospital, London, UK.From the Division of Surgery and Interventional Science, University College London, Royal Free Hospital, London, UK.From the Division of Surgery and Interventional Science, University College London, Royal Free Hospital, London, UK.Background:. Breast cancer is the most prevalent cancer and second leading cause of cancer-related deaths in both the US and UK female population, a prominent cause of morbidity and cost to both health services. All surgically fit patients are offered breast reconstruction following the initial surgery, and this is traditionally an open approach: either implant-based or an autologous tissue flap. Both lead to scarring that is difficult to conceal. This paper aims to evaluate the novel minimally invasive technique of robotic-assisted surgery. Methods:. A systematic review was conducted using Medline (OvidSP) and Embase (OvidSP) to evaluate the current application of robotic-assisted surgery in breast surgery and reconstruction. Results:. Twenty-one articles were identified and discussed, composing of level 4 and 5 evidence comparing different surgeons' experiences, techniques, and outcomes. To date, the robotic system has been utilized to harvest the latissimus dorsi muscle for use as a tissue flap (total harvest time of 92 minutes), to perform nipple-sparing mastectomy with immediate breast reconstruction (total operation time 85 minutes) and lately to harvest a deep inferior epigastric perforator flap via an intraabdominal approach. Conclusions:. Robotic-assisted surgery can successfully and reproducibly perform a nipple-sparing mastectomy with breast reconstruction. It can minimize the size of scarring and is superior to the laparoscopic technique, with improved 3-dimensional visualization, dexterity, and range of motion able to guide around the curvature of the breast. The main limiting factors are the lack of the US Food and Drug Administration approval, cost of the robot, and specialized skills required.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002578 |
| spellingShingle | Edward Donnely, MBBS, BSc (Hons), MRCS Michelle F. Griffin, MBChB, MRes MSc, MRCS, PhD Peter E. Butler, MD, FRCSI, FRCS (Plast) Robotic Surgery: A Novel Approach for Breast Surgery and Reconstruction Plastic and Reconstructive Surgery, Global Open |
| title | Robotic Surgery: A Novel Approach for Breast Surgery and Reconstruction |
| title_full | Robotic Surgery: A Novel Approach for Breast Surgery and Reconstruction |
| title_fullStr | Robotic Surgery: A Novel Approach for Breast Surgery and Reconstruction |
| title_full_unstemmed | Robotic Surgery: A Novel Approach for Breast Surgery and Reconstruction |
| title_short | Robotic Surgery: A Novel Approach for Breast Surgery and Reconstruction |
| title_sort | robotic surgery a novel approach for breast surgery and reconstruction |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002578 |
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