Download PDF
CC BY-NC-ND 4.0 · Arch Plast Surg 2022; 49(03): 373-377
DOI: 10.1055/s-0042-1748647
Breast/Trunk
Idea and Innovation

Single-Port Transaxillary Robot-Assisted Latissimus Dorsi Muscle Flap Reconstruction for Poland Syndrome: Concomitant Application of Robotic System to Contralateral Augmentation Mammoplasty

Yong-Jae Hwang
1   Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
,
Jae-Ho Chung
1   Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
,
Hyung-Chul Lee
1   Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
,
Seung-Ha Park
1   Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
,
Eul-Sik Yoon
1   Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
› Author Affiliations Funding None.
› Further Information
   Permissions and Reprints

Abstract

Currently, robot-assisted latissimus dorsi muscle flap (RLDF) surgery is used in treating patients with Poland syndrome and for breast reconstruction. However, conventional RLDF surgery has several inherent issues. We resolved the existing problems of the conventional system by introducing the da Vinci single-port system in patients with Poland syndrome. Overall, three patients underwent RLDF surgery using the da Vinci single-port system with gas insufflation. In the female patient, after performing RLDF with silicone implant, augmentation mammoplasty was also performed on the contralateral side. Both surgeries were performed as single-port robotic-assisted surgery through the transaxillary approach. The mean operating time was 449 (335–480) minutes; 8.67 (4–14) minutes were required for docking and 59 (52–67) minutes for robotic dissection and LD harvesting. No patients had perioperative complication and postoperative problems related to gas inflation. The single-port robot-assisted surgical system overcomes the drawbacks of previous robotic surgery in patients with Poland syndrome, significantly shortens the procedure time of robotic surgery, has superior cosmetic outcomes in a surgical scar, and improves the operator's convenience. Furthermore, concurrent application to another surgery demonstrates the possibility in the broad application of the robotic single-port surgical system.

Keywords

Poland syndrome - robotic surgical procedures - surgical flaps - mammoplasty - breast implants

Author Contributions

Conceptualization: E.-S.Y. Data Curation: Y.-J.H., H.-C.L. Formal analysis: S.-H.P., Y.-J.H. Methodology: H.-C.L., Y.-J.H. Writing-original draft: Y.-J.H. Writing-review and editing: E.-S.Y., H.-C.L., S.-H.P.


Ethical Approval

The study was approved by the Institutional Review Board of Korea University Anam Hospital (IRB No. 2021AN0333) and performed in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained.


Patient Consent

The patients provided written informed consent for the publication and the use of their images.


Prior Presentation

This article was presented at the 11th Research & Reconstruction Forum on May 7–8, 2021.




Publication History

Article published online:
27 May 2022

© 2022. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Ahn SJ, Song SY, Park HS. et al. Early experiences with robot-assisted prosthetic breast reconstruction. Arch Plast Surg 2019; 46 (01) 79-83
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Ciudad P, Date S, Lee MH. et al. Robotic harvest of a right gastroepiploic lymph node flap. Arch Plast Surg 2016; 43 (02) 210-212
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Song HG, Yun IS, Lee WJ, Lew DH, Rah DK. Robot-assisted free flap in head and neck reconstruction. Arch Plast Surg 2013; 40 (04) 353-358
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Jeon DN, Kim J, Ko BS. et al. Robot-assisted breast reconstruction using the prepectoral anterior tenting method. J Plast Reconstr Aesthet Surg 2021; 74 (11) 2906-2915
    CrossrefPubMedGoogle Scholar
  • 5 Selber JC. The robotic DIEP flap. Plast Reconstr Surg 2020; 145 (02) 340-343
    CrossrefPubMedGoogle Scholar
  • 6 Moon KC, Yeo HD, Yoon ES. et al. Robotic-assisted latissimus dorsi muscle flap for autologous chest reconstruction in Poland syndrome. J Plast Reconstr Aesthet Surg 2020; 73 (08) 1506-1513
    CrossrefPubMedGoogle Scholar
  • 7 Chung JH, You HJ, Kim HS, Lee BI, Park SH, Yoon ES. A novel technique for robot assisted latissimus dorsi flap harvest. J Plast Reconstr Aesthet Surg 2015; 68 (07) 966-972
    CrossrefPubMedGoogle Scholar
  • 8 Selber JC, Baumann DP, Holsinger FC. Robotic latissimus dorsi muscle harvest: a case series. Plast Reconstr Surg 2012; 129 (06) 1305-1312
    CrossrefPubMedGoogle Scholar
  • 9 Winocour S, Tarassoli S, Chu CK, Liu J, Clemens MW, Selber JC. Comparing outcomes of robotically assisted latissimus dorsi harvest to the traditional open approach in breast reconstruction. Plast Reconstr Surg 2020; 146 (06) 1221-1225
    CrossrefPubMedGoogle Scholar
  • 10 Houvenaeghel G, Bannier M, Rua S. et al. Robotic breast and reconstructive surgery: 100 procedures in 2-years for 80 patients. Surg Oncol 2019; 31: 38-45
    CrossrefPubMedGoogle Scholar
  • 11 Joo OY, Song SY, Park HS, Roh TS. Single-port robot-assisted prosthetic breast reconstruction with the da Vinci SP Surgical System: first clinical report. Arch Plast Surg 2021; 48 (02) 194-198
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Lee H, Lee J, Lee K, Kim JY, Park HS. Comparison between gasless and gas-inflated robot-assisted nipple-sparing mastectomy. J Breast Cancer 2021; 24 (02) 183-195
    CrossrefPubMedGoogle Scholar
  • 13 Gutt CN, Oniu T, Mehrabi A. et al. Circulatory and respiratory complications of carbon dioxide insufflation. Dig Surg 2004; 21 (02) 95-105
    CrossrefPubMedGoogle Scholar