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J Reconstr Microsurg
DOI: 10.1055/a-2717-4610
Original Article

Single Port Robotic Vascularized Omental Lymph Node Transfer for Lymphedema: A Novel Comparison to Open Technique

Authors

  • Jonathan L. Jeger   ‡

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Phoenix, Arizona, United States

  • Lyndsay Kandi   ‡

    2   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago, Illinois, United States

  • Johnny Yi

    3   Department of Medical and Surgical Gynecology, Mayo Clinic, Phoenix, Arizona, United States

  • W. Nicholas Jungbauer  Jr

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Phoenix, Arizona, United States

  • Chad M. Teven

    4   Division of Plastic Surgery, Department of Surgery, Northwestern Medicine, Chicago, Illinois, United States

  • William J. Casey III

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Phoenix, Arizona, United States

  • Alanna Rebecca   ‡‡

    1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Phoenix, Arizona, United States
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Abstract

Background

The da Vinci Single-Port (SP) system is a robotic surgery platform that 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 two 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 two groups. Ninety-three percent 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 the open to the SP approach.

Keywords

vascularized lymph node transfer - lymphedema - omentum

Ethical Approval

This study was exempt from IRB approval.


Note

In one patient, failure of primary closure of the recipient site following flap inset resulted in the placement of a temporizing Integra Dermal Regeneration Template. Preliminary findings of this study were presented at the 2023 Mountain West Society of Plastic Surgery meeting.


‡ These authors share first authorship.


‡‡ Senior author




Publication History

Received: 10 May 2025

Accepted: 20 September 2025

Accepted Manuscript online:
10 October 2025

Article published online:
28 October 2025

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