Comparison of Robotic and Conventional Techniques in Breast Reconstruction: A Scoping Review on Safety, Efficacy, and Aesthetic Outcomes
PDF (Português (Brasil))

Keywords

breast reconstruction; robotic techniques; open surgery; deep inferior epigastric perforator flap; latissimus dorsi flap.

How to Cite

Bezerra, G. J. A., & Neto, J. T. P. D. (2025). Comparison of Robotic and Conventional Techniques in Breast Reconstruction: A Scoping Review on Safety, Efficacy, and Aesthetic Outcomes. Brazilian Journal of Implantology and Health Sciences, 7(4), 1252–1268. https://doi.org/10.36557/2674-8169.2025v7n4p1252-1268

Abstract

Introduction: Breast reconstruction is essential in the treatment of breast cancer, improving the physical and emotional recovery and quality of life of patients. In this sense, robotic technologies have revolutionized autologous reconstruction. Objective: To compare the efficacy, safety and aesthetic outcomes of robotic and conventional techniques in breast reconstruction. Methods: This consists of a scoping review performed through the Scopus, Embase, PubMed® and SciELO databases, using the descriptors: breast reconstruction, robotics, open surgery, surgical flaps. Studies published in the last 12 years, in English, Spanish or Portuguese, that addressed the topic were included. Results and discussions: The robotic approach reduced pain, complications and scars, although it requires more operative time and infrastructure. Conventional techniques remain useful in complex cases, but with more complications and less aesthetic benefit. Conclusion: Robotic techniques show aesthetic and recovery advantages in breast reconstruction, despite challenges such as cost and infrastructure. Conventional techniques remain useful in complex cases, but future studies are essential to assess cost-effectiveness and long-term outcomes.

https://doi.org/10.36557/2674-8169.2025v7n4p1252-1268
PDF (Português (Brasil))

References

BARZAMAN, K. et al. Breast cancer: biology, biomarkers, and treatments. International Immunopharmacology, v. 84, jul. 2020.

CHANG, E. I. et al. Comprehensive analysis of donor-site morbidity in abdominally based free flap breast reconstruction. Plastic and Reconstructive Surgery, v. 132, n. 6, p. 1383–1391, 2013.

CLEMENS, M. W.; KRONOWITZ, S.; SELBER, J. C. Robotic-assisted latissimus dorsi harvest in delayed-immediate breast reconstruction. Seminars in Plastic Surgery, v. 28, n. 1, p. 20-25, fev. 2014.

DE LORENZI, F. et al. Oncoplastic breast-conserving surgery for tumors larger than 2 centimeters: is it oncologically safe? A matched-cohort analysis. Annals of Surgical Oncology, v. 23, n. 6, p. 1852-1859, jun. 2016.

EO PS et al. Robot-assisted latissimus dorsi flap harvest for partial breast reconstruction: comparison with endoscopic and conventional approaches. Aesthetic Surgery Journal, v. 44, n. 1, p. 38-46, dez. 2023.

FAUCONNIER, M. et al. Comparison of postoperative complications following conventional latissimus dorsi flap versus muscle-sparing latissimus dorsi flap breast reconstruction. Journal of Plastic, Reconstructive & Aesthetic Surgery, v. 75, n. 10, p. 3653–3663, 2022.

Hanson SE, Lei X, Roubaud MS, DeSnyder SM, Caudle AS, Shaitelman SF, Hoffman KE, Smith GL, Jagsi R, Peterson SK, Smith BD. Long-term Quality of Life in Patients With Breast Cancer After Breast Conservation vs Mastectomy and Reconstruction. JAMA Surg. 2022 Jun 1;157(6):e220631.

HOUVENAEGHEL, G. et al. Robotic versus conventional latissimus dorsi-flap harvested for immediate breast reconstruction. Journal of Surgical Research, v. 4, n. 4, p. 749–764, 2021.

HOUVENAEGHEL, G. et al. Robotic-assisted skin sparing mastectomy and immediate reconstruction using latissimus dorsi flap: a new effective and safe technique: a comparative study. Surgical Oncology, v. 35, p. 406-411, dez. 2020.

KELSALL, J. E. et al. Comparing oncoplastic breast conserving surgery with mastectomy and immediate breast reconstruction: case-matched patient reported outcomes. Journal of Plastic, Reconstructive & Aesthetic Surgery, v. 70, n. 10, p. 1377-1385, out. 2017.

LAI, H. W. et al. Robotic nipple sparing mastectomy and immediate breast reconstruction with robotic latissimus dorsi flap harvest–technique and preliminary results. Journal of Plastic, Reconstructive & Aesthetic Surgery, v. 71, n. 10, p. e59–e61, 2018.

LEE, M. J. et al. Clinical outcomes following robotic versus conventional DIEP flap in breast reconstruction: a retrospective matched study. Frontiers in Oncology, v. 12, p. 989231, 14 set. 2022.

PUSIC, A. L. et al. Patient-reported outcomes 1 year after immediate breast reconstruction: results of the mastectomy reconstruction outcomes consortium study. Journal of Clinical Oncology, v. 35, n. 22, p. 2499–2506, 2017.

Schaefer KM, Kappos EA, Haug M, Schaefer DJ. Brustrekonstruktion – der Einfluss des Verfahrens auf die Lebensqualität [Breast Reconstruction: Impact of the Procedure on Quality of Life]. Handchir Mikrochir Plast Chir. 2022 Aug;54(4):349-355. German.

SELBER, J. C. The robotic DIEP flap. Plastic and Reconstructive Surgery, v. 145, n. 2, p. 340–343, 2020.

SELBER, J. C.; BAUMANN, D. P.; HOLSINGER, C. F. Robotic harvest of the latissimus dorsi muscle: laboratory and clinical experience. Journal of Reconstructive Microsurgery, v. 28, n. 7, p. 457–464, 2012.

Shah V, Soh CL, Chhatwal K, Kucharczak J, Airapetyan AA, Avavde D, Torabi S, Mackenzie A, Miller G, Vardanyan R, Arjomandi Rad A, Malawana J. Autologous breast reconstruction in low- and middle-income countries (LMICs): a systematic review of current practices and challenges. Minerva Surg. 2024 Feb;79(1):73-81.

SOOD, R. et al. Latissimus dorsi flap in breast reconstruction: recent innovations in the workhorse flap. Cancer Control, v. 25, n. 1, p. 1073274817744638, 2018.

TSAI, C. Y. et al. Novel port placement in robot-assisted DIEP flap harvest improves visibility and bilateral DIEP access: early controlled cohort study. Plastic and Reconstructive Surgery, v. 152, n. 4, p. 590e-595e, out. 2023.

WINOCOUR, S. et al. Comparing outcomes of robotically assisted latissimus dorsi harvest to the traditional open approach in breast reconstruction. Plastic and Reconstructive Surgery, v. 146, n. 6, p. 1221-1225, dez. 2020.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2025 Gustavo José Araújo Bezerra, Joaquim Thomaz Pereira Diegues Neto

Downloads

Download data is not yet available.
1 1