Skip to main content

Robotic Breast Reconstruction with the Latissimus Dorsi Flap

  • Chapter
  • First Online:
Robotics in Plastic and Reconstructive Surgery
  • 414 Accesses

Abstract

The recent advent of robotic-assisted technology has allowed for significant advances in minimally invasive surgery, essentially freeing physicians from the physical limitations of their own hands. Robotic-assisted surgery has successfully integrated into urology, surgical oncology, gynecology, and thoracic surgery, but plastic surgical indications remain a relatively novel frontier. For two-stage, delayed-immediate reconstruction of the breast, robotic-assisted latissimus dorsi harvest (RALDH) is an excellent option for patients who wish to avoid a traditional latissimus dorsi donor-site incision. In this chapter, we review indications for robotic-assisted surgery in breast reconstruction, pertinent anatomy, patient selection, technique, and institutional outcomes. 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, and for the properly selected patient eliminates the need for a donor-site incision.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ascherman JA, Hanasono MW, Newman MI, Hughes DB. Implant reconstruction in breast cancer patients with radiation therapy. Plast Reconstr Surg. 2006;117:359–65.

    Article  CAS  Google Scholar 

  2. Spear SL, Onyewu C. Staged breast reconstruction with saline-filled implants in the irradiated breast: recent trends and therapeutic implications. Plast Reconstr Surg. 2000;105:930–42.

    Article  CAS  Google Scholar 

  3. Kronowitz SJ, Robb GL. Radiation therapy and breast reconstruction: a critical review of the literature. Plast Reconstr Surg. 2009;124(2):395–408.

    Article  CAS  Google Scholar 

  4. Tran NV, Chang DW, Gupta A, et al. Comparison of immediate and delayed TRAM flap breast reconstruction in patients receiving postmastectomy radiation therapy. Plast Reconstr Surg. 2001;108:78.

    Article  CAS  Google Scholar 

  5. Spear SL, Boehmler J, Clemens MW. The latissimus flap in the irradiated breast. In: Spear SL, editor. Surgery of the breast: principles and art. 3rd ed. Philadelphia: Lippincott-Raven; 2011.

    Google Scholar 

  6. Kronowitz SJ, Hunt KK, Kuerer HM, et al. Delayed-immediate breast reconstruction. Plast Reconstr Surg. 2004;113:1617.

    Article  Google Scholar 

  7. Kronowitz SJ. Immediate versus delayed reconstruction. Clin Plast Surg. 2007;96:39.

    Article  Google Scholar 

  8. Kronowitz SJ. Delayed-immediate breast reconstruction: technical and timing considerations. Plast Reconstr Surg. 2010;125(2):463–74.

    Article  CAS  Google Scholar 

  9. Selber JC. Robotic latissimus dorsi muscle harvest. Plast Reconstr Surg. 2011;128:88e–90e.

    Article  CAS  Google Scholar 

  10. Selber JC, Baumann DP, Holsinger FC. Robotic latissimus dorsi muscle harvest: a case series. Plast Reconstr Surg. 2012;129(6):1305–12.

    Article  CAS  Google Scholar 

  11. Lin CH, Wei FC, Levin LS, Chen MC. Donor-site morbidity comparison between endoscopically assisted and traditional harvest of free latissimus dorsi muscle flap. Plast Reconstr Surg. 1999;104:1070–7; quiz 1078; review erratum Plast Reconstr Surg. 2000;105:823.

    Article  CAS  Google Scholar 

  12. Pomel C, Missana MC, Lasser P. Endoscopic harvesting of the latissimus dorsi flap in breast reconstructive surgery: feasibility study and review of the literature. Ann Chir. 2002;127:337–42.

    Article  CAS  Google Scholar 

  13. Motwami SB, Strom EA, Schechter NR, et al. The impact of immediate breast reconstruction on the technical delivery of postmastectomy radiotherapy. Int J Radiat Oncol Biol Phys. 2006;66:76.

    Article  Google Scholar 

  14. Clemens MW, Kronowitz S, Selber JC. Robotic-assisted latissimus dorsi harvest in delayed-immediate breast reconstruction. Semin Plast Surg. 2014;28(1):20–5.

    Article  Google Scholar 

Download references

Conflict of Interest

None of the authors have any relevant financial relationships or affiliations to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mark W. Clemens .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Clemens, M.W., Selber, J.C. (2021). Robotic Breast Reconstruction with the Latissimus Dorsi Flap. In: Selber, J.C. (eds) Robotics in Plastic and Reconstructive Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-74244-7_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-74244-7_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-74243-0

  • Online ISBN: 978-3-030-74244-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics