BackgroundThis study reports the preliminary results of da Vinci robot XI robot‐assisted nipple‐sparing mastectomy immediate breast reconstruction (R‐NSMIBR) with gel implant and latissimus dorsi muscle flap.MethodsA total of 15 patients who underwent R‐NSMIBR with gel implant and latissimus dorsi muscle flap surgery for breast cancer between September 2022 and November 2022 were evaluated.ResultsMean total operative time for R‐NSMIBR was 361.9 ± 77.0 min. As the learning curve increased, the robot arm docking time decreased rapidly from the initial 25–10 min. Average total blood loss was 27.8 ± 10.7 mL and posterior surgical margin positivity rate was 0%. Perioperative complications and local recurrences or deaths were not observed at a mean follow‐up of 3 ± 1 month 15 patients were satisfied with postoperative aesthetic results.ConclusionsR‐NSMIBR with a gel implant and latissimus dorsi muscle flap could be a new therapeutic option for breast reconstruction.