Robotic-assisted latissimus dorsi in delayed immediate breast reconstruction
Epublication WebSurg.com, May 2014;14(05). URL: http://websurg.com/doi/lt03enclemens001
Background: For two-stage delayed-immediate reconstruction of the radiated breast, robotic-assisted latissimus dorsi harvest (RALDH) is a secondary option for patients who wish to avoid a donor site incision. The purpose of this study was to compare outcomes of RALDH versus a traditional open technique (TOT) for patients undergoing delayed-immediate breast reconstruction following radiation therapy. Methods: A retrospective analysis of a prospective database of all consecutive patients undergoing latissimus dorsi harvest for radiated breast reconstruction between 2009 and 2013 was performed. Indications, surgical technique, complications and outcomes were assessed. Results: 146 pedicled latissimus dorsi muscle flaps were performed for breast reconstruction and 17 were performed with robotic assistance during the study period (average follow-up 14.6 ±7.3 months). Latissimus dorsi breast reconstruction following radiation was performed in 64 TOT patients and 12 RALDH patients. Surgical complication rates were 37.5% TOT versus 16.7% RALDH (p=0.31), which included seroma (8.9% vs. 8.3%), infection (14.1 vs. 8.3%), wound healing (7.8% vs. 0), and capsular contracture (4.7% vs. 0). Conclusion: RALDH is associated with a low complication rate and reliable results for reconstruction of the irradiated breast while obviating the need for a donor site incision.