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Semin Plast Surg 2014; 28(01): 020-025
DOI: 10.1055/s-0034-1368163
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Robotic-Assisted Latissimus Dorsi Harvest in Delayed-Immediate Breast Reconstruction

Mark W. Clemens
1   Department of Plastic Surgery, MD Anderson Cancer Center, University of Texas, Houston, Texas
,
Steven Kronowitz
1   Department of Plastic Surgery, MD Anderson Cancer Center, University of Texas, Houston, Texas
,
Jesse C. Selber
1   Department of Plastic Surgery, MD Anderson Cancer Center, University of Texas, Houston, Texas
› Author Affiliations
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Publication History

Publication Date:
07 March 2014 (online)

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Abstract

For two-stage, implant-based, delayed-immediate reconstruction of the radiated breast, robotic-assisted latissimus dorsi harvest (RALDH) is a good option for patients who wish to avoid a traditional latissimus dorsi donor-site incision. The purpose of this study was to compare outcomes of RALDH and the traditional open technique (TOT) for patients undergoing delayed-immediate breast reconstruction following radiation therapy. A retrospective analysis of a prospective database of all consecutive patients undergoing latissimus dorsi harvest for radiated breast reconstruction between 2009 and 2013 was performed. Indications, surgical technique, complications, and outcomes were assessed. One hundred forty-six pedicled latissimus dorsi muscle flaps were performed for breast reconstruction and 17 were performed robotically during the study period (average follow-up 14.6 ± 7.3 mo). Latissimus dorsi breast reconstruction following radiation was performed in 64 patients using TOT and 12 using RALDH. Surgical complication rates were 37.5% in TOT versus 16.7% in RALDH (p = 0.31) including seroma (8.9% versus 8.3%), infection (14.1 versus 8.3%), delayed wound healing (7.8% versus 0), and capsular contracture (4.7% vs. 0). Robotic-assisted harvest of the latissimus dorsi muscle is associated with a low complication rate and reliable results for delayed reconstruction of the irradiated breast while eliminating the need for a donor-site incision.

Keywords

robotic assisted - delayed immediate - latissimus dorsi - radiated breast - breast reconstruction
 

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