Evaluation of safety and operative time in tumescent-free robotic nipple-sparing mastectomy: a retrospective single-center cohort study

• Published in: Annals of surgical treatment and research 2024, 107(1), , pp.08-15
• Main Authors: Hwang, Yung-Huyn, Han, Hyun Ho, Eom, Jin Sup, Yoo, Tae-Kyung Robyn, Kim, Jisun, Chung, Il Yong, Ko, BeomSeok, Kim, Hee Jeong, Lee, Jong Won, Son, Byung Ho, Lee, Sae Byul
• Format: Article
• Language: English
• Subjects: Original; 일반외과학
• ISSN: 2288-6575; 2288-6796
• DOI: 10.4174/astr.2024.107.1.8

Tumescent in nipple-sparing mastectomy (NSM) has been reported to increase the risk of necrosis by impairing blood flow to the skin flap and nipple-areolar complex. At our institution, we introduced a tumescent-free robotic NSM using the da Vinci single-port system (Intuitive Surgical, Inc.). We conducted a retrospective analysis of patients who underwent tumescent-free robotic NSM between October 2020 and March 2023 at Asan Medical Center (Seoul, Korea). Clinicopathological characteristics, adverse events, and operative time were evaluated. During the study period, 118 patients underwent tumescent-free robotic NSM. Thirty-one patients (26.3%) experienced an adverse event. Five patients (4.2%) were classified as grade III based on the Clavien-Dindo classification and required surgery. The mean total operative time was 467 minutes for autologous tissue reconstruction (n = 49) and 252 minutes for implants (n = 69). No correlation was found between the cumulative number of surgical cases and the breast operative time (P = 0.30, 0.52, 0.59 for surgeons A, B, C) for the 3 surgeons. However, a significant linear relationship (P < 0.001) was observed, with the operative time increasing by 13 minutes for every 100-g increase in specimen weight. Tumescent-free robotic NSM is a safe procedure with a feasible operative time and few adverse events.