Single Incision Latissimus Dorsi Flap for Breast Reconstruction After Robot-Assisted Mastectomy: a Report of Three Cases

Abstract

Mastectomy using robotic devices has recently been the preferred surgical approach for creating a precise, small incision. Although the latissimus dorsi technique is the only safe option for breast reconstruction after robot-assisted mastectomy, it remains difficult to obtain a sufficient tissue volume when approaching the latissimus dorsi muscle flap. This case series aimed to report a reconstruction method that modified the extended latissimus dorsi flap design considering scar visibility and introduced a single incision technique in three cases. This technique allows surgeons to design a latissimus dorsi flap as an extension of a robot-assisted mastectomy incision to prevent scar formation on the breast mound and to perform breast reconstruction using autologous tissue to create a single scar. Robot-assisted mastectomy was performed through an approximately 4–5-cm incision in the mid-axillary line by drawing a horizontal line. The latissimus dorsi flap included an incision. Although the post-surgical scar may be relatively long, scar visibility is substantially low. Patients with small to moderate breast volumes, such as Asians, do not need implants, and the scar can be covered by underwear linings and their arms. In one case, postoperative radiotherapy was performed but the volume and shape of the reconstructed breast were appropriately maintained. In conclusion, the single incision technique is a useful modification technique that allows immediate breast reconstruction using autologous tissue for patients who had undergone robot-assisted mastectomy to prevent scar formation on their breast mounds.