Table 2.
Data Extraction: Breast Reconstruction Using Robotic Surgery
| Study | Title | Year | Journal | Aim | Sample Size | Robot |
|---|---|---|---|---|---|---|
| Boyd et al17 | Robotic harvest of internal mammary vessels in breast reconstruction | 2006 | J Reconstr Microsurg | To harvest the intermammary vessels using the robot (similar to standard technique in cardiac surgery), then traditional free flap approach | 22 free flaps on 20 patients | Aesop voice-activated robotic arm |
| Selber et al18 | Robotic harvest of the latissimus dorsi muscle: laboratory and clinical experience | 2012 | J Reconstr Microsurg | To evaluate the robotic harvest of the LD muscle in a cadaver model for use in patient clinical series | 8 fresh human cadavers; harvesting 10 LD muscles. Clinical series—8 LD flaps (6 for pedicled implant-based breast reconstruction) |
Da Vinci Si |
| Selber et al19 | Robotic latissimus dorsi muscle harvest: a case series | 2012 | Plast Reconstr Surg | The first clinical report of robotic harvest of the LD muscle | 7 LD muscles were harvested; 5 for breast reconstruction (3 for immediate implant based, 2 for radiated breasts exchanging for an implant | Da Vinci |
| Clemens et al20 | Robotic-assisted latissimus dorsi harvest in delayed-immediate breast reconstruction | 2014 | Semin Plast Surg | To compare outcomes of RALDH and TOT for patients undergoing delayed–immediate reconstruction following RT | 76 patients; 64 using TOT (average f/u 16.4 mo), 12 using RALDH (average f/u 12.3 mo) | Da Vinci |
| Chung et al21 | A novel technique for robot assisted latissimus dorsi flap harvest | 2015 | J Plast Reconstr Aesthet Surg | To introduce a new technique using an articulated long retractor for transaxillary gasless robot-assisted LD muscle harvest | 12 muscles flaps; mean age 35.8 y, mean BMI 23.1 | Da Vinci |
| Toesca et al23 | Preliminary report of robotic nipple-sparing mastectomy and immediate breast reconstruction with implant (poster abstract) |
2015 |
Eur J Cancer (Conference) |
“Aim of this study is to evaluate feasibility, safety, advantages and limitations of robotic surgery applied to the nipple-sparing mastectomy (NSM) and immediate breast reconstruction with implant (IBRI).” | 3 prophylactic NSM with IBR for BRCA-positive patients with prior breast cancer on contralateral side | Da Vinci Si |
| Sarfati et al29 | Robotic-assisted nipple sparing mastectomy: a feasibility study on cadaveric models | 2016 | J Plast Reconstr Aesthet Surg | To evaluate the technical feasibility of R-NSM through lateral axillary incision using cadavers | 4 breasts from 2 fresh female human cadavers | Da Vinci |
| Toesca et al25 | Robotic nipple sparing mastectomy and immediate breast reconstruction: future prospectives for breast cancer surgery (conference abstract) |
2016 |
Eur J Cancer (Conference) |
“The aim of our study is to evaluate the applicability of robotic surgery also for breast cancer patients.” | 10 patients with breast cancer or DCIS underwent 11 robotic mastectomies | Da Vinci (unknown model) |
| Toesca et al22 | Robotic nipple-sparing mastectomy and immediate breast reconstruction with implant: first report of surgical technique | 2017 | Ann Surg | To evaluate feasibility, safety, advantages, and limitations of robotic surgery to perform NSM and IBR with implant | 3 prophylactic NSM with IBR for BRCA-positive patients with prior breast cancer on contralateral side | Da Vinci Si |
| Toesca et al24 | Robotic nipple-sparing mastectomy for the treatment of breast cancer: feasibility and safety study | 2017 | Breast | To describe the outcome of the first 29 consecutive R-NSM and IBR procedures performed and assess feasibility, reproducibility and safety | 24 female patients; 18 for breast cancer, 6 for prophylaxis with BRCA mutation | Da Vinci Si |
| Sarfati et al33 | Robotic nipple-sparing mastectomy with immediate prosthetic breast reconstruction: a preliminary study (conference abstract) |
2017 | Cancer Research Conference | “The aim of this prospective study was to assess feasibility of the RNSM with immediate prosthetic breast reconstruction (IPBR) on the first 50 consecutive cases performed in Gustave Roussy.” | 50 patients with RNSM with IPBR | Unknown |
| Lai et al27 | Robotic nipple-sparing mastectomy and immediate breast reconstruction with gel implant | 2018 | Plast Reconstr Surg Glob Open | To report the preliminary experience and results of R-NSM and IBR with gel implant | 15 patients with breast cancer; mean age 46.5 y (30.8% DCIS, 30.8% stage 1, 30.8% stage 2, 7.7% stage 3) | Da Vinci |
| Lai et al26 | Robotic nipple-sparing mastectomy and immediate breast reconstruction with gel implant: technique, preliminary results and patient-reported cosmetic outcome | 2018 | Ann Surg Oncol | To report the preliminary experience and results of R-NSM and IBR with gel implant | 22 patients with 23 R-NSM and IBR. Mean age 48.9 y. | Da Vinci |
| Lai et al28 | The learning curve of robotic nipple sparing mastectomy for breast cancer: an analysis of consecutive 39 procedures with cumulative sum plot | 2018 | Eur J Surg Oncol | To report the preliminary experience of R-NSM in the management of breast cancer and analyze the learning curve from the same surgeon | 39 R-NSM from 35 patients; mean age 49.8 y | Da Vinci |
| Sarfati et al29 | Robotic da Vinci Xi-assisted nipple-sparing mastectomy: first clinical report | 2018 | Breast J | To describe the surgical technique and postoperative outcome of the first case of NSM with da Vinci robot | Case report; 46-y-old woman. Prophylactic bilateral NSM with BRCA2 positive | Da Vinci |
| Sarfati et al31 | Robotic nipple-sparing mastectomy with immediate prosthetic breast reconstruction: surgical technique | 2018 | Plast Reconstr Surg | To describe the surgical technique, the authors have developed from experience gained from over 60 procedures | 32 patients with 60 procedures | Da Vinci |
| Sarfati et al32 | Robotic prophylactic nipple-sparing mastectomy with immediate prosthetic breast reconstruction: a prospective study | 2018 | Ann Surg Oncol | To assess the feasibility and safety of R-NSM with IPBR | 33 female patients underwent 63 R-NSM with IPBR (all prophylactic except 1 for DCIS). Mean age 37 y, mean BMI 20.9. | Da Vinci |
| Lai et al35 | Technique for single axillary incision robotic assisted quadrantectomy and immediate partial breast reconstruction with robotic latissimus dorsi flap harvest for breast cancer: a case report | 2018 | Medicine (Baltimore) | To report preliminary experience and clinical outcome of RAQ and IPBR with RLDFH | Case report; 28-y-old woman. Triple-negative breast cancer T3N1M0. Final pathology T2N0M0 and stage 2A. | Da Vinci |
| Gundlapalli et al37 | Robotic-assisted deep inferior epigastric artery perforator flap abdominal harvest for breast reconstruction: a case report | 2018 | Microsurgery | To report the use of robot to harvest the DIEV in a DIEP flap breast reconstruction | Case report; 51-y-old woman | Da Vinci |
| Ahn et al34 | Early experiences with robot-assisted prosthetic breast reconstruction | 2019 | Arch Plast Surg | “We describe several patients with invasive ductal carcinoma who underwent robot-assisted nipple-sparing mastectomy and implant-based immediate breast reconstruction with satisfactory results.” | 4 patients with invasive ductal carcinoma | Da Vinci Xi |
| Houvenaeghel et al36 | Breast cancer robotic nipple sparing mastectomy: evaluation of several surgical procedures and learning curve | 2019 | World J Surg Oncol | “To report feasibility of robotic NSM and determine standard surgical procedure and learning curve threefold.” | 27 patients; 22 invasive, and 5 in situ BC | Da Vinci Si and Xi |
BMI, body mass index; DCIS, ductal carcinoma in-situ; DIEP, deep inferior epigastric artery perforator; f/u, follow up; IPBR, immediate prosthetic breast reconstruction; RAQ, robotic-assisted quadrantectomy; RLDFH, robotic LD flap harvest; RT, radiotherapy.