Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea.
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.
J Robot Surg. 2023 Aug;17(4):1429-1434. doi: 10.1007/s11701-023-01539-5. Epub 2023 Feb 5.
Although some surgeons prefer anterolateral thigh and latissimus dorsi flap for soft tissue reconstruction in the head and neck area because it minimizes donor site complications, the radial forearm flap remains the workhorse for soft tissue reconstruction due to its reliability. To reduce donor site morbidity, the authors developed a novel technique for radial forearm flap harvesting using a robotic device. 42 radial forearm free flap reconstruction cases were studied, consisting of 31 conventional and 11 robot-assisted cases. 1:1 propensity score matching was done according to age, sex, previous and postoperative radiation therapy history and method used for vein anastomosis. There was no significant difference in flap outcome, which was 100% vitality in the robot-assisted group and 90.9% vitality in the conventional group. The robot-assisted group showed significantly longer mean harvesting time than did the conventional group, being 107.2 min and 67.0 min, respectively. Robot-assisted radial forearm flap harvesting can reduce donor site complications by minimizing incision. When more surgical experience is gained under appropriate case selection, we expect our robot-assisted method will yield a harvesting time similar to that of the conventional method and thus become more reliable and feasible.
虽然一些外科医生更喜欢使用前外侧大腿和背阔肌皮瓣进行头颈部的软组织重建，因为这样可以最大限度地减少供区并发症，但由于其可靠性，桡侧前臂皮瓣仍然是软组织重建的首选。为了减少供区并发症，作者开发了一种使用机器人设备进行桡侧前臂皮瓣采集的新技术。研究了 42 例桡侧前臂游离皮瓣重建病例，其中 31 例为传统方法，11 例为机器人辅助方法。根据年龄、性别、既往和术后放疗史以及静脉吻合方法，采用 1:1 倾向评分匹配进行匹配。皮瓣结果无显著差异，机器人辅助组皮瓣活力为 100%，传统组为 90.9%。机器人辅助组的平均采集时间明显长于传统组，分别为 107.2 分钟和 67.0 分钟。机器人辅助桡侧前臂皮瓣采集可以通过最小化切口来减少供区并发症。当在适当的病例选择下获得更多的手术经验后，我们预计我们的机器人辅助方法将产生与传统方法相似的采集时间，从而变得更加可靠和可行。
