Laparoscopy allows the harvest of the DIEP flap with shorter fascial incisions as compared to endoscopic harvest: A single surgeon retrospective cohort study

Shakir, Sameer; Spencer, Amy B.; Piper, Merisa; Kozak, Geoffrey M.; Soriano, Ian; Kanchwala, Suhail

doi:10.1016/j.bjps.2020.10.098

Cited by 20 publications

(31 citation statements)

References 25 publications

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“…While the venous anastomosis was performed manually, arterial anastomosis of the deep inferior epigastric artery to the internal mammary artery was performed by the surgeon using the da Vinci. Since then, harvesting of free flaps such as the DIEP has been performed multiple times using the da Vinci [ 11 , 12 , 13 , 14 ].…”

Section: Resultsmentioning

confidence: 99%

“…Bishop et al [ 21 ] described the outcome of 21 patients 12 months postoperatively after harvesting DIEP vessels by using a small posterior incision as a safe and reliable technique. Other studies have described the benefits of a minimal fascial incision for flap harvesting when compared with the traditional approach [ 11 , 12 , 13 , 14 ].…”

Section: Resultsmentioning

confidence: 99%

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Robotic-Assisted Microsurgery and Its Future in Plastic Surgery

Aitzetmüller

Klietz

Dermietzel

et al. 2022

JCM

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Within the last 20 years, robotic-assisted surgeries have been implemented as routine procedures in many surgical fields, except in plastic surgery. Although several case series report promising results, technical and economic aspects have prevented its translation into clinical routine. This review is based on a PubMed and Google Scholar database search, including case reports, case series, clinical and preclinical trials, as well as patents. Past, recent approaches, ongoing patents, as well as eight specific systems for robotic-assisted microsurgery and their potential to be translated into a clinical routine, are described. They may lay the ground for a novel field within plastic surgery. This review provides an overview of the emerging technologies and clinical and preclinical studies and discusses the potential of robotic assistance in the field of plastic surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Robotic-Assisted Microsurgery and Its Future in Plastic Surgery

Aitzetmüller

Klietz

Dermietzel

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…No studies reported the sex distribution. Two studies were comparative retrospective studies 25 , 26 , and the other was a case series. 27 …”

Section: Resultsmentioning

confidence: 99%

“…Shakir et al (2021) compared endoscopic, laparoscopic, and robotic harvest of deep inferior epigastric perforator (DIEP) flaps for breast reconstruction. 26 There were 135 patients in total: robotic (n=3), endoscopic (n=94), and total extraperitoneal laparoscopic (TEP-lap) (n=38). There were no instances of complications in the robotic and laparoscopic cohort, compared to two cases of flap loss in the endoscopic cohort.…”

Section: Resultsmentioning

confidence: 99%

Does plastic surgery need a rewiring? A survey and systematic review on robotic-assisted surgery

et al. 2022

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“…When compared to the robotic approach, proponents of laparoscopic DIEP flap harvest cite the greater availability of laparoscopic equipment, the ability to perform harvest more easily via an extraperitoneal approach without violating the posterior rectus sheath, and decreased cost (Shakir et al, 2020; Shakir et al, 2021). Nevertheless, a few limitations of laparoscopy make the robotic technique a potentially preferred modality.…”

Section: Discussionmentioning

confidence: 99%

Robotic deep inferior epigastric perforator flap harvest in breast reconstruction

et al. 2022

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Introduction Reducing donor site morbidity after deep inferior epigastric artery perforator (DIEP) flap harvest relies mainly upon maintaining integrity of the anterior rectus sheath fascia. The purpose of this study is to describe our minimally‐invasive technique for robotic DIEP flap harvest. Methods A retrospective review of four patients undergoing seven robotic‐assisted DIEP flaps from 2019 to 2020 was conducted. Average patient age and BMI were 52 years (range: 45–60 years) and 26.7 kg/m2 (range: 20.6–32.4 kg/m2), respectively. Average follow‐up was 6.31 months (range: 5.73–7.27 months). Robotic flap harvest was performed with intramuscular perforator dissection in standard fashion, followed by the transabdominal preperitoneal (TAPP) approach to DIEP pedicle harvest using the da Vinci Xi robot. Data was collected on demographic information, perioperative characteristics. Primary outcomes included successful flap harvest as well as donor site morbidity (e.g., abdominal bulge, hernia, bowel obstruction, etc.). Results All four patients underwent bilateral abdominally‐based free flap reconstruction. Three patients received bilateral robotic DIEP flaps, and one patient underwent unilateral robotic DIEP flap reconstruction. The da Vinci Xi robot was used in all cases. Average flap weight and pedicle length were 522 g (range: 110–809 g) and 11.2 cm (range: 10–12 cm), respectively. There were no flap failures, and no patient experienced abdominal wall donor site morbidity on physical exam. Conclusion While further studies are needed to validate its use, this report represents the largest series of robotic DIEP flap harvests to date and is a valuable addition to the literature.

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Laparoscopy allows the harvest of the DIEP flap with shorter fascial incisions as compared to endoscopic harvest: A single surgeon retrospective cohort study

Cited by 20 publications

References 25 publications

Robotic-Assisted Microsurgery and Its Future in Plastic Surgery

Robotic-Assisted Microsurgery and Its Future in Plastic Surgery

Does plastic surgery need a rewiring? A survey and systematic review on robotic-assisted surgery

Robotic deep inferior epigastric perforator flap harvest in breast reconstruction

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