Page 83 - Read Online

Page 8 of 10 Hammond et al. Plast Aesthet Res 2024;11:28 https://dx.doi.org/10.20517/2347-9264.2024.27

Figure 7. Robotic closure of the posterior sheath after DIEP flap harvest; DIEP= deep inferior epigastric perforator.

not significantly differ from a standard postoperative care pathway. In adopting a robotic approach to
autologous breast reconstruction, the authors recommend maintaining the standard practice for enhanced
recovery postoperative care tailored to individual patient needs, provider preferences, and institutional
policies (i.e. flap assessment/monitoring, anticoagulation, use of surgical drains, etc.).

CLINICAL OUTCOMES AND COMPLICATIONS
In the modern era of robotic surgery, many of the beneficial outcomes in other surgical specialties also
[14]
apply to breast reconstruction . When comparing outcomes between traditional and robotic latissimus flap
reconstruction, a robotic approach is associated with a shorter hospital length of- stay and lower
postoperative opioid requirements; contemporary data even show higher patient satisfaction due to the
smaller scars resulting from a robotic approach [10,15] . For robotic DIEP flap reconstruction, outcomes from
several studies also report favorable results with no flap losses, intraabdominal complications, or
postoperative hernia/bulge; Lee et al. even report significantly improved abdominal physical well-being with
robotic DIEP harvest compared to a conventional approach [13,16-18] . Functional abdominal wall data
comparing traditional and robotic DIEP flap harvest has not yet been published Table 1.

With the adoption of any new surgical technology, some notable limitations exist. As is the case for robotic
breast reconstruction, these limitations include the costs of robotic surgery implementation and surgeon/
operating team learning curves . The institutional costs associated with acquiring and maintaining a
[19]
[20]
surgical robot are considered cost-prohibitive by some medical centers . Furthermore, at centers where a