Robot-Assisted Latissimus Dorsi Flap Harvest for Partial Breast Reconstruction: Comparison With Endoscopic and Conventional Approaches

Abstract Background Latissimus dorsi muscle flaps are widely utilized in breast reconstruction. Several methods have been introduced. Objectives The aim was to compare the outcomes of robot-assisted breast reconstruction with a latissimus dorsi muscle flap following partial mastectomy with the outcomes of conventional and endoscopic-assisted techniques. Methods In this prospective single-institution study, Korean females diagnosed with breast cancer who underwent partial mastectomy and breast reconstruction with a latissimus dorsi flap from March 2020 to December 2021 were included. The outcomes of surgery and patient satisfaction utilizing the conventional, endoscopic-assisted, and robot-assisted techniques were compared. Results In total, 57 patients were included in this study, among whom 20 underwent conventional reconstruction, and 17 and 20 patients underwent endoscopic and robotic surgery, respectively. There was no statistically significant difference between the 3 methods in postoperative opioid analgesic dosage (P = .459), hospitalization period (P = .225), or the average total amount of donor site drainage during hospitalization (P = .175). With regard to patient satisfaction after surgery, especially regarding the donor site scar, the conventional method showed a significantly lower score than the other 2 techniques. Conclusions Robot-assisted breast reconstruction with a latissimus dorsi muscle flap after partial mastectomy showed higher patient satisfaction than that for the conventional open method. Because robotic surgery is more convenient than the endoscopic technique, it is potentially a good alternative to conventional open or endoscopic surgery. Level of Evidence: 4