Background:
The da Vinci® Single-Port (SP) system is a robotic surgery platform which allows access
into the abdominal cavity through a single short surgical incision. The omentum is
an attractive donor site for vascularized omental lymph node transfer (VOLT) in the
treatment of lymphedema. We hypothesize that SP robotic VOLT will allow for improvement
in perioperative outcomes as compared to open laparotomy for omental flap harvest.
Methods:
A retrospective cohort study was performed, comprised of a study sample of patients
with a diagnosis of lymphedema who presented to our institution for VOLT using either
an open or SP robotic technique between May 2020 and February 2023. The primary outcome
was length of hospital stay. The secondary outcomes included intraoperative complication
rate, postoperative complication rate, and length of surgery.
Results:
Fifteen patients underwent da Vinci® SP omental flap harvest and 14 patients underwent
open harvest. There was no significant difference in average age, BMI, sex, or lymphedema
etiology between the 2 groups. Average length of stay was 2.2 ± 1.7 days in the SP
group and 2.3 ± 2.1 days in the open group (p=0.91). There were no significant differences
in terms of intraoperative or postoperative complications between the 2 groups. 93%
of SP robotic and 86% of open patients reported at least partial subjective improvement
following VOLT (p=0.50).
Conclusion:
Our findings suggest that SP robotic omental harvest for VOLT is feasible. Perioperative
outcomes show comparable results in terms of length of hospital stay, complications,
and subjective postoperative improvement when comparing open to SP approach.
