Abstract
For two-stage, implant-based, delayed-immediate reconstruction of the radiated breast,
robotic-assisted latissimus dorsi harvest (RALDH) is a good option for patients who
wish to avoid a traditional latissimus dorsi donor-site incision. The purpose of this
study was to compare outcomes of RALDH and the traditional open technique (TOT) for
patients undergoing delayed-immediate breast reconstruction following radiation therapy.
A retrospective analysis of a prospective database of all consecutive patients undergoing
latissimus dorsi harvest for radiated breast reconstruction between 2009 and 2013
was performed. Indications, surgical technique, complications, and outcomes were assessed.
One hundred forty-six pedicled latissimus dorsi muscle flaps were performed for breast
reconstruction and 17 were performed robotically during the study period (average
follow-up 14.6 ± 7.3 mo). Latissimus dorsi breast reconstruction following radiation
was performed in 64 patients using TOT and 12 using RALDH. Surgical complication rates
were 37.5% in TOT versus 16.7% in RALDH (p = 0.31) including seroma (8.9% versus 8.3%), infection (14.1 versus 8.3%), delayed
wound healing (7.8% versus 0), and capsular contracture (4.7% vs. 0). 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 while eliminating
the need for a donor-site incision.
Keywords
robotic assisted - delayed immediate - latissimus dorsi - radiated breast - breast
reconstruction
