Roy Nikita, Alessandro Christopher J, Ibelli Taylor J, Akhavan Arya A, Sharaf Jake M, Rabinovitch David, Henderson Peter W, Yao Alice
Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
SUNY Downstate Medical School, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA.
J Clin Med. 2023 Jul 27;12(15):4951. doi: 10.3390/jcm12154951.
The expansion of robotic surgery has led to developments in robotic-assisted breast reconstruction techniques. Specifically, robotic flap harvest is being evaluated to help maximize operative reliability and reduce donor site morbidity without compromising flap success. Many publications are feasibility studies or technical descriptions; few cohort analyses exist. This systematic review aims to characterize trends in robotic autologous breast reconstruction and provide a summative analysis of their results. A systematic review was conducted using PubMed, Medline, Scopus, and Web of Science to evaluate robot use in breast reconstruction. Studies dated from 2006 to 2022 were identified and analyzed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Full-text, peer-reviewed, English-language, and human subject studies were included. Non-breast reconstruction articles, commentary, expert opinion, editor's letter, and duplicate studies were excluded. A total of 17 full-text articles were analyzed. The two robotic breast procedures identified were the deep inferior epigastric perforator (DIEP) and the latissimus dorsi (LD) flap. Results showed comparable complication rates and increased operative times compared to NSQIP data on their corresponding open techniques. Additional findings reported in studies included patient reported outcomes, incision lengths, and downward trends in operative time with consecutive procedures. The available data in the literature confirms that robotic surgery is a promising alternative to traditional open methods of breast reconstruction following mastectomy.
机器人手术的扩展推动了机器人辅助乳房重建技术的发展。具体而言，正在评估机器人皮瓣采集技术，以在不影响皮瓣成功率的情况下，最大程度地提高手术可靠性并降低供区并发症发生率。许多出版物都是可行性研究或技术描述；队列分析很少。本系统评价旨在描述机器人自体乳房重建的趋势，并对其结果进行总结分析。使用PubMed、Medline、Scopus和Web of Science进行了一项系统评价，以评估机器人在乳房重建中的应用。确定了2006年至2022年的研究，并根据系统评价和Meta分析的首选报告项目（PRISMA）指南进行分析。纳入全文、同行评审、英文和人体研究。排除非乳房重建文章、评论、专家意见、编辑信件和重复研究。共分析了17篇全文文章。确定的两种机器人乳房手术方法是腹壁下深动脉穿支（DIEP）皮瓣和背阔肌（LD）皮瓣。结果显示，与相应开放技术的国家外科质量改进计划（NSQIP）数据相比，并发症发生率相当，但手术时间延长。研究报告的其他发现包括患者报告的结果、切口长度以及连续手术时手术时间的下降趋势。文献中的现有数据证实，机器人手术是乳房切除术后传统开放乳房重建方法的一种有前景的替代方案。
