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Semin Plast Surg 2023; 37(03): 188-192
DOI: 10.1055/s-0043-1771236
Review Article

Robotic Rectus Abdominis Harvest for Pelvic Reconstruction after Abdominoperineal Resection

Richard Appel
1   Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
,
Linden Shih
1   Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
,
Alejandro Gimenez
1   Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
,
Caroline Bay
1   Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
,
Christy Yoon-Hee Chai
2   Division of Surgical Oncology, Baylor College of Medicine, Houston, Texas
,
Marco Maricevich
1   Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
› Institutsangaben Funding None.
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Abstract

The use of robotic surgical systems to perform abdominoperineal resection (APR) has recently become more prevalent. This minimally invasive approach produces fewer scars and potentially less morbidity for the patient. The rectus abdominis muscle is often used for reconstruction after APR if primary closure is not feasible or the surgical site is at high risk of wound complications. Since the traditional open harvest of this flap creates large incisions that negate the advantages of minimally invasive APR, there has been growing interest in harvesting the rectus abdominis in a similarly robotic fashion. This article reviews the technique, benefits, and limitations of this robotic technique. Compared to the traditional open harvest, robotic harvest of the rectus abdominis leaves smaller scars, provides technical benefits for the surgeon, and offers possible morbidity benefits for the patient. These advantages should be weighed against the added expense and learning curve inherent to robotic surgery.

Keywords

abdominoperineal resection - robotic surgery - plastic surgery - rectus abdominis flap


Publikationsverlauf

Artikel online veröffentlicht:
25. Juli 2023

© 2023. Thieme. All rights reserved.

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

 

  • References

  • 1 Hawkins AT, Albutt K, Wise PE. et al; Continuing Education Committee of the SSAT. Abdominoperineal resection for rectal cancer in the twenty-first century: indications, techniques, and outcomes. J Gastrointest Surg 2018; 22 (08) 1477-1487
    CrossrefPubMedSuche in Google Scholar
  • 2 Taylor JP, Stem M, Althumairi AA. et al. Minimally invasive proctectomy for rectal cancer: a national perspective on short-term outcomes and morbidity. World J Surg 2020; 44 (09) 3130-3140
    CrossrefPubMedSuche in Google Scholar
  • 3 Zacharopoulou C, Sananes N, Baulon E, Garbin O, Wattiez A. Robotic gynecologic surgery: state of the art. Review of the literature. J Gynecol Obstet Biol Reprod (Paris) 2010; 39 (06) 444-452
    PubMedSuche in Google Scholar
  • 4 Yuh BE, Hussain A, Chandrasekhar R. et al. Comparative analysis of global practice patterns in urologic robot-assisted surgery. J Endourol 2010; 24 (10) 1637-1644
    CrossrefPubMedSuche in Google Scholar
  • 5 Ibrahim AE, Sarhane KA, Baroud JS, Atiyeh BS. Robotics in plastic surgery, a review. Eur J Plast Surg 2012; 35 (08) 571-578
    CrossrefPubMedSuche in Google Scholar
  • 6 Pedersen J, Song DH, Selber JC. Robotic, intraperitoneal harvest of the rectus abdominis muscle. Plast Reconstr Surg 2014; 134 (05) 1057-1063
    CrossrefPubMedSuche in Google Scholar
  • 7 Chung JS, Kim WT, Ham WS. et al. Comparison of oncological results, functional outcomes, and complications for transperitoneal versus extraperitoneal robot-assisted radical prostatectomy: a single surgeon's experience. J Endourol 2011; 25 (05) 787-792
    CrossrefPubMedSuche in Google Scholar
  • 8 Martin AD, Nunez RN, Castle EP. Robot-assisted radical cystectomy versus open radical cystectomy: a complete cost analysis. Urology 2011; 77 (03) 621-625
    CrossrefPubMedSuche in Google Scholar
  • 9 Waters JA, Canal DF, Wiebke EA. et al. Robotic distal pancreatectomy: cost effective?. Surgery 2010; 148 (04) 814-823
    CrossrefPubMedSuche in Google Scholar
  • 10 Copeland-Halperin LR, Stewart T, Chen Y, Funderburk CD, Freed GL. Perineal reconstruction following abdominoperineal resection: comprehensive review of the literature. J Plast Reconstr Aesthet Surg 2020; 73 (11) 1924-1932
    CrossrefPubMedSuche in Google Scholar
  • 11 Ibrahim AE, Sarhane KA, Pederson JC, Selber JC. Robotic harvest of the rectus abdominis muscle: principles and clinical applications. Semin Plast Surg 2014; 28 (01) 26-31
    Thieme ConnectPubMedSuche in Google Scholar
  • 12 Hammond JB, Howarth AL, Haverland RA. et al. Robotic harvest of a rectus abdominis muscle flap after abdominoperineal resection. Dis Colon Rectum 2020; 63 (09) 1334-1337
    CrossrefPubMedSuche in Google Scholar
  • 13 Asaad M, Pisters LL, Klein GT. et al. Robotic rectus abdominis muscle flap following robotic extirpative surgery. Plast Reconstr Surg 2021; 148 (06) 1377-1381
    CrossrefPubMedSuche in Google Scholar
  • 14 Sonderman PL, Sanger JR, Yousif NJ, Matloub HS. Transfer of an inferior rectus abdominis myocutaneous flap following enterostomy. Ann Plast Surg 1992; 29 (06) 585-586
    CrossrefPubMedSuche in Google Scholar
  • 15 Davila AA, Goldman J, Kleban S. et al. Reducing complications and expanding use of robotic rectus abdominis muscle harvest for pelvic reconstruction. Plast Reconstr Surg 2022; 150 (01) 190-195
    CrossrefPubMedSuche in Google Scholar
  • 16 Haverland R, Rebecca AM, Hammond J, Yi J. A case series of robot-assisted rectus abdominis flap harvest for pelvic reconstruction: a single institution experience. J Minim Invasive Gynecol 2021; 28 (02) 245-248
    CrossrefPubMedSuche in Google Scholar
  • 17 Ascherman JA, Seruya M, Bartsich SA. Abdominal wall morbidity following unilateral and bilateral breast reconstruction with pedicled TRAM flaps: an outcomes analysis of 117 consecutive patients. Plast Reconstr Surg 2008; 121 (01) 1-8
    CrossrefPubMedSuche in Google Scholar
  • 18 Chun YS, Sinha I, Turko A. et al. Comparison of morbidity, functional outcome, and satisfaction following bilateral TRAM versus bilateral DIEP flap breast reconstruction. Plast Reconstr Surg 2010; 126 (04) 1133-1141
    CrossrefPubMedSuche in Google Scholar
  • 19 Singh P, Teng E, Cannon LM, Bello BL, Song DH, Umanskiy K. Dynamic article: tandem robotic technique of extralevator abdominoperineal excision and rectus abdominis muscle harvest for immediate closure of the pelvic floor defect. Dis Colon Rectum 2015; 58 (09) 885-891
    CrossrefPubMedSuche in Google Scholar
  • 20 Oliver JD, Hammoudeh ZS, Akhavan AA, Tran NV. Flap reconstruction of gastrointestinal-to-genitourinary fistulas: a 20-year experience. J Reconstr Microsurg 2019; 35 (07) 479-484
    Thieme ConnectPubMedSuche in Google Scholar
  • 21 Agochukwu N, Bonaroti A, Beck S, Liau J. Laparoscopic harvest of the rectus abdominis for perineal reconstruction. Plast Reconstr Surg Glob Open 2017; 5 (11) e1581
    CrossrefPubMedSuche in Google Scholar
  • 22 Greensmith A, Januszkiewicz J, Poole G. Rectus abdominis muscle free flap harvest by laparoscopic sheath-sparing technique. Plast Reconstr Surg 2000; 105 (04) 1438-1441
    PubMedSuche in Google Scholar
  • 23 Winters BR, Mann GN, Louie O, Wright JL. Robotic total pelvic exenteration with laparoscopic rectus flap: initial experience. Case Rep Surg 2015; 2015: 835425
    PubMedSuche in Google Scholar
  • 24 Pang JH, Patel SA, King SA, Curcillo II PG, Weiss ES, Buchanan DR. Reduced-port approach to laparoscopic flap harvest (RALFH): an anterior sheath sparing rectus abdominis flap. J Plast Reconstr Aesthet Surg 2017; 70 (05) 710-712
    CrossrefPubMedSuche in Google Scholar
  • 25 Johnston DB, McBrearty A, Armstrong A. Laparoscopic mobilization of a rectus abdominis myofascial flap for the prevention of perineal hernia post-abdominoperineal resection of the rectum: a feasibility study?. Surg Innov 2015; 22 (06) 656
    CrossrefPubMedSuche in Google Scholar
  • 26 Soomro NA, Hashimoto DA, Porteous AJ. et al. Systematic review of learning curves in robot-assisted surgery. BJS Open 2020; 4 (01) 27-44
    CrossrefPubMedSuche in Google Scholar
  • 27 Flynn J, Larach JT, Kong JCH, Waters PS, Warrier SK, Heriot A. The learning curve in robotic colorectal surgery compared with laparoscopic colorectal surgery: a systematic review. Colorectal Dis 2021; 23 (11) 2806-2820
    CrossrefPubMedSuche in Google Scholar
  • 28 Kalchwala SK, Shakir S. Minimally invasive harvest of the DIEP flap: a comparison of endoscopic, laparoscopic, and robotic techniques. Paper presented at: 2020 Annual Meeting of the American Society for Reconstructive Microsurgery. ; January 10–14, 2020 ; Ft. Lauderdale, FL
    PubMedSuche in Google Scholar