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Ann Surg Oncol. 2019 Jan;26(1):42-52. doi: 10.1245/s10434-018-6704-2. Epub 2018 Aug 14.

Robotic Nipple-Sparing Mastectomy and Immediate Breast Reconstruction with Gel Implant: Technique, Preliminary Results and Patient-Reported Cosmetic Outcome.

Lai HW1,2,3,4,5,6,7,8, Chen ST9,10,11, Lin SL12, Chen CJ13,14,15, Lin YL9,16, Pai SH9,16, Chen DR9,10,11, Kuo SJ10,11.

Author information

1
Endoscopic and Oncoplastic Breast Surgery Center, Changhua Christian Hospital, Changhua, Taiwan. 143809@cch.org.tw.
2
Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan. 143809@cch.org.tw.
3
Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan. 143809@cch.org.tw.
4
School of Medicine, National Yang Ming University, Taipei, Taiwan. 143809@cch.org.tw.
5
Division of Breast Surgery, Yuanlin Christian Hospital, Yuanlin, Taiwan. 143809@cch.org.tw.
6
Minimally Invasive Surgery Research Center, Changhua Christian Hospital, Changhua, Taiwan. 143809@cch.org.tw.
7
Kaohsiung Medical University, Kaohsiung, Taiwan. 143809@cch.org.tw.
8
School of Medicine, Chung Shan Medical University, Taichung, Taiwan. 143809@cch.org.tw.
9
Endoscopic and Oncoplastic Breast Surgery Center, Changhua Christian Hospital, Changhua, Taiwan.
10
Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan.
11
Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan.
12
Division of Plastic and Reconstructive Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.
13
School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
14
Department of Pathology, Changhua Christian Hospital, Changhua, Taiwan.
15
Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
16
Minimally Invasive Surgery Research Center, Changhua Christian Hospital, Changhua, Taiwan.

Abstract

BACKGROUND:

Experience with application of a robotic surgery platform in the management of breast cancer is limited. The preliminary results of the robotic nipple-sparing mastectomy (R-NSM) and immediate breast reconstruction (IBR) with Gel implant procedure are reported.

METHODS:

The medical records of patients from a single institution who underwent an R-NSM and IBR with Gel implant procedure for breast cancer during the period March 2017 to February 2018 were assessed. Data on clinicopathologic characteristics, type of surgery, complications, and recurrence were analyzed to determine the effectiveness and oncologic safety of R-NSM. Patient-reported cosmetic outcome results were obtained.

RESULTS:

A total of 22 patients who received 23 R-NSM and IBR with Gel implant procedures were analyzed. The mean operation time for R-NSM was 118.8 ± 50.6 min, and 74.5 ± 26.6 min for Gel implant reconstruction. Docking time quickly dropped from 20 to 6-8 min, and the time needed to complete R-NSM was usually completed within 100 min after accumulation of case experience. Mean blood loss was 37 ± 38.2 mL, and the positive surgical margin rate was 0%. Three (13%) patients had transit nipple ischemia change, and no total nipple-areolar complex necrosis cases were observed. No local recurrence or mortality was found during a mean 6.9 ± 3.5 months of follow-up. All 22 patients were satisfied with the postoperative aesthetic outcome.

CONCLUSION:

From our preliminary experience, R-NSM and IBR with Gel implant is a safe procedure, with good cosmetic results, and could be a promising new technique for breast cancer patients indicated for mastectomy.

PMID:
30109537
DOI:
10.1245/s10434-018-6704-2
[Indexed for MEDLINE]

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