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CC BY 4.0 · Brazilian Journal of Oncology 2022; 18: e-20220317
DOI: 10.5935/2526-8732.20220317
Original Article
Oncological Surgery

Robotic nipple-sparing mastectomy for cancer risk reduction: demonstration of applicability and surgical results

Mastectomia poupadora de mamilo robótica para redução do risco de câncer: demonstração de aplicabilidade e resultados cirúrgicos
Rodrigo Bernardi 
1   Department of Oncogynecology and Mastology, Hospital Erasto Gaertner, Curitiba (PR), Brazil
,
José Clemente Linhares
1   Department of Oncogynecology and Mastology, Hospital Erasto Gaertner, Curitiba (PR), Brazil
,
Audrey Tsunoda
1   Department of Oncogynecology and Mastology, Hospital Erasto Gaertner, Curitiba (PR), Brazil
,
Sérgio Bruno Bonatto Hatschbach
1   Department of Oncogynecology and Mastology, Hospital Erasto Gaertner, Curitiba (PR), Brazil
,
Reitan Ribeiro
1   Department of Oncogynecology and Mastology, Hospital Erasto Gaertner, Curitiba (PR), Brazil
,
Anne Karoline Groth
2   Department of Plastic Surgery, Hospital Erasto Gaertner, Curitiba (PR), Brazil
,
Isabeli Lopes Kruk
3   Medical School Student, Faculdade Pequeno Príncipe (FPP), Curitiba (PR), Brazil
› Author Affiliations Financial support: None to declare
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ABSTRACT

Introduction: Robotic nipple sparing mastectomy (RNSM) may be a breakthrough for breast cancer risk reduction surgeries, providing better aesthetic results. This study aims to spread the knowledge of the robotic surgical technique, still little performed in the world, and to demonstrate the applicability and surgical results.

Methods: RNSM was offered to patients with small or medium volume breasts, ptosis up to grade 2, and all with genetic mutations at increased risk for breast cancer. The Surgical System da Vinci Si® (Intuitive Surgical, Sunnyvale, CA) was used for the surgeries. The satisfaction of each patient and the time of the surgeries were evaluated.

Results: A total of 4 patients underwent surgery, all of whom had genetic mutations that would make breast cancer prevalent. The duration of the surgery was drastically reduced from 6h20min to 3h in the last surgery. There were no serious complications, such as prosthesis loss or nipple necrosis. Skin burning was noted in two patients, with complete resolution over the weeks.

Conclusion: RNSM has a fast-learning curve and excellent aesthetic results in patients who fit the criteria for surgery.

RESUMO

Introdução: A mastectomia poupadora de mamilos robótica (MPMR) pode ser um avanço para cirurgias de redução de risco de câncer de mama, proporcionando melhores resultados estéticos. Este estudo visa difundir o conhecimento da técnica cirúrgica robótica, ainda pouco realizada no mundo, e demonstrar a aplicabilidade e os resultados cirúrgicos.

Métodos: O MPMR foi oferecido a pacientes com mamas de pequeno ou médio volume, ptose até grau 2 e todas com mutações genéticas com risco aumentado para câncer de mama. O Surgical System da Vinci Si® (Intuitive Surgical, Sunnyvale, CA) foi utilizado para as cirurgias. A satisfação de cada paciente e o tempo das cirurgias foram avaliados.

Resultados: Foram operadas 4 pacientes, todos com mutações genéticas que tornariam o câncer de mama prevalente. A duração da cirurgia foi drasticamente reduzida de 6h20min para 3h na última cirurgia. Não houve complicações graves, como perda da prótese ou necrose mamilar. Queimação na pele foi observada em dois pacientes, com resolução completa ao longo das semanas.

Conclusão: O MPMR apresenta curva de aprendizado rápido e excelentes resultados estéticos em pacientes que se enquadram nos critérios para cirurgia.

Keywords:

Prophylactic mastectomy - Robotic surgical procedures - Breast neoplasms

Palavras-chave:

Mastectomia profilática - Procedimentos cirúrgicos robóticos - Neoplasias mamárias


Publication History

Received: 09 November 2021

Accepted: 15 January 2022

Article published online:
09 March 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Rodrigo Bernardi, José Clemente Linhares, Audrey Tsunoda, Sérgio Bruno Bonatto Hatschbach, Reitan Ribeiro, Anne Karoline Groth, Isabeli Lopes Kruk. Robotic nipple-sparing mastectomy for cancer risk reduction: demonstration of applicability and surgical results. Brazilian Journal of Oncology 2022; 18: e-20220317.
DOI: 10.5935/2526-8732.20220317
 

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