Can Nipple-sparing Mastectomy and Immediate Breast Reconstruction with Modified Extended Latissimus Dorsi Muscular Flap Improve the Cosmetic and Functional Outcome among Patients with Breast Carcinoma?

2007 ◽  
Vol 31 (6) ◽  
pp. 1171-1179 ◽  
Author(s):  
Adel Denewer ◽  
Omar Farouk
Keyword(s):  
Breast Carcinoma ◽  
Breast Reconstruction ◽  
Functional Outcome ◽  
Latissimus Dorsi ◽  
Immediate Breast Reconstruction ◽  
Muscular Flap ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

scholarly journals Robotic harvest of a latissimus dorsi flap using a single-port surgical robotic system in breast reconstruction

2021 ◽  
Vol 48 (6) ◽  
pp. 577-582
Author(s):  
Oh Young Joo ◽  
Seung Yong Song ◽  
Dae Hyun Lew ◽  
Hyung Seok Park ◽  
Dong Won Lee
Keyword(s):  
Minimally Invasive ◽  
Breast Reconstruction ◽  
Latissimus Dorsi ◽  
Single Port ◽  
Immediate Breast Reconstruction ◽  
Robot Assisted ◽  
Invasive Approach ◽  
Robotic Arms ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Robot-assisted surgery is evolving to incorporate a higher number of minimally invasive techniques. There is a growing interest in robotic breast reconstruction that uses autologous tissue. Since a traditional latissimus dorsi (LD) flap leads to a long donor scar, which can be an unpleasant burden to patients, there have been many attempts to decrease the scar length using minimally invasive approaches. This study presents the case of a patient who underwent a robot-assisted nipple-sparing mastectomy followed by immediate breast reconstruction with an LD flap using a single-port robotic surgery system. With the assistance of a single-port robot, a simple docking process using a short and less visible incision is possible. Compared to multiport surgery systems, single-port robots can reduce the possibility of collision between robotic arms and provide a clear view of the medial border of the LD where the curvature of the back restricts the visual field. We recommend the use of single-port robots as a minimally invasive approach for harvesting LD flaps.

scholarly journals A Retrospective Study of Latissimus Dorsi Flap in Immediate Breast Reconstruction

2021 ◽  
Vol 11 ◽  
Author(s):  
Hongmei Zheng ◽  
Guodong Zhu ◽  
Qing Guan ◽  
Wei Fan ◽  
Xiang Li ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Latissimus Dorsi ◽  
Muscle Flap ◽  
Immediate Breast Reconstruction ◽  
Cosmetic Outcome ◽  
Latissimus Dorsi Flap ◽  
Latissimus Dorsi Muscle Flap ◽  
Advantages And Disadvantages ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

BackgroundThere are many different methods used for immediate breast reconstruction, but the advantages and disadvantages between distinct methods are not reported and compared directly.MethodsWe collected the data of patients who underwent breast reconstruction from 2010 to 2015 and classified a total of 103 patients into three groups: i) skin- or nipple-sparing mastectomy with implant and partial latissimus dorsi flap (MIPLD); ii) skin- or nipple-sparing mastectomy with the whole latissimus dorsi flap (MWLD); and iii) breast-conserving surgery and partial latissimus dorsi flap (BCSPLD). The outcome, safety, and cosmetic outcome of the latissimus dorsi muscle flap with or without implant were reported and compared.ResultsThe procedures were successful in all cases. None of the patients had severe complications. The 5-year distant metastasis-free survival is 94.2%. All the patients exhibited good arm and back function. Based on the evaluation of the BREAST-Q score, the cosmetic outcome of Satisfaction with Breasts was excellent or good in 97.8% of the cases.ConclusionsMIPLD, MWLD, and BCSPLD stand for three distinct methods for immediate breast reconstruction with good outcome and aesthetic effect. They were safe, were easy to perform, and provided quick recovery and good quality of life. Therefore, these three breast reconstructive methods are worthy of widespread use in clinical practice and provide different ways to reconstruct the breast according to the patients’ conditions and preferences.

scholarly journals Robot-assisted Nipple-sparing Mastectomy with Immediate Breast Reconstruction: An Initial Experience

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Hyung Seok Park ◽  
Jeea Lee ◽  
Dong Won Lee ◽  
Seung Yong Song ◽  
Dae Hyun Lew ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Learning Curve ◽  
Operation Time ◽  
Immediate Breast Reconstruction ◽  
Robot Assisted ◽  
Open Conversion ◽  
Areolar Complex ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Abstract Seeking smaller and indistinct incisions, physicians have attempted endoscopic breast surgery in breast cancer patients. Unfortunately, there are some limitations in the range of movement and visualization of the operation field. Potentially addressing these limitations, we investigated the outcomes of gas and gasless robot-assisted nipple-sparing mastectomy (RANSM) with immediate breast reconstruction (IBR). Ten patients underwent 12 RANSM with IBR between November 2016 and April 2018. Patients with tumors measuring >5 cm in diameter, tumor invasion of the skin or nipple-areolar complex, proven metastatic lymph nodes, or planned radiotherapy were excluded. Age, breast weight, diagnosis, tumor size, hormone receptor status, and operation time were retrospectively collected. Postoperative outcomes including postoperative complications and final margin status of resected were analyzed. The median total operation time and console time were 351 min (267–480 min) and 51 min (18–143 min), respectively. The learning curve presented as a cumulative sum graph showed that the console time decreased and then stabilized at the eighth case. There was no open conversion or major postoperative complication. One patient had self-resolved partial nipple ischemia, and two patients experienced partial skin ischemia. We deemed that RANSM with IBR is safe and feasible for early breast cancer, benign disease of the breast, and BRCA 1/2 mutation carriers. RANSM is an advanced surgical method with a short learning curve.

Robotic Nipple-Sparing Mastectomy and Immediate Breast Reconstruction With Robotic Latissimus Dorsi Flap Harvest: Technique and Results

2020 ◽  
pp. 155335062091791
Author(s):  
Gilles Houvenaeghel ◽  
Monique Cohen ◽  
Sandrine Rua Ribeiro ◽  
Julien Barrou ◽  
Mellie Heinemann ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Complication Rate ◽  
Surgical Procedure ◽  
Latissimus Dorsi ◽  
Immediate Breast Reconstruction ◽  
Latissimus Dorsi Flap ◽  
Axillary Lymph ◽  
Grade 3 ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Introduction. Only few cases of robotic latissimus dorsi flap reconstruction (RLDFR) have been reported in indication of reconstruction for breast cancer (BC). We report our experience of combined robotic nipple-sparing mastectomy (R-NSM) and RLDFR, and analyze technique, indications, and reproducibility. Methods. All patients with R-NSM and RLDFR from November 2016 to August 2, 2018, were analyzed, and technics have been described. Complication rate with Clavien-Dindo grading and postoperative hospitalization length (days) are reported. Results. Thirty-five R-NSM with RLDFR were performed in 22 cases for primitive BC and 13 for local recurrence. In 12 patients, another surgical procedure was performed during the same time (axillary lymph node dissection or contralateral breast surgery). R-NSM was realized through a short axillar incision, with inside-only installation for 12 patients (34.3%): 18 nonautologous and 17 autologous RLDFR associated with implant in 9 patients. In logistic regression, mastectomy weight >330 g was significantly associated with the use of implant (odds ratio [OR] = 17, P = .015), and significant factor of the time of anesthesia ≥380 minutes was 2 installations (OR = 10.4, P = .049). The median duration of hospitalization stay was 4 days. Complications rates were 51.4% (18/35; 9 grade-1, 2 grade-2, and 7 grade-3). In logistic regression, associated other surgical procedure was predictive of grade-3 complications (OR = 6.87, P = .053). Conclusion. We confirmed the reproducibility and safety of R-NSM and RLDFR with a decreased complication rate. NSM was performed in 42.8% of our patients after previous radiotherapy. We observed an increase of grade-3 complications when R-NSM and RLDFR was combined to another surgical procedure.

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