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. 2020 Jun 15;9(6):e769-e773.
doi: 10.1016/j.eats.2020.02.008. eCollection 2020 Jun.

Robotic Transfer of the Latissimus Dorsi

Jose Carlos Garcia Jr  1 , Eduardo Ferreira Cordeiro  1 , Maurício de Paiva Raffaelli  1 , Marcelo Boulos Dumans Mello  1 , Márcio Eduardo Kozonara  1 , Álvaro da Motta Cardoso Jr  1 , Marcelo Cerdan Torres  2
Affiliations

Robotic Transfer of the Latissimus Dorsi

Jose Carlos Garcia Jr et al. Arthrosc Tech. .

Abstract

Robotic surgery has been used for a long time; it is earning space and its use is expanding in daily medical practice in several surgical specialties, with advantages over traditional surgical methods. This Technical Note presents an endoscopic robotic posterior shoulder approach that allows the surgeon to perform latissimus dorsi transfer endoscopically. This Technical Note describes the use of the da Vinci robot (Intuitive Surgical, Sunnyvale, CA) for transfers related to rotator cuff tears.

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Figures

Fig 1
Fig 1
Patient in ventral decubitus position. Right shoulder and thorax. (A, B) Robotic hand trocars. (C) Optics trocar. (D) Shoulder. (E) Robotic exterior hand. (F) Robotic exterior hand for optics.
Fig 2
Fig 2
A robotic optic of 30° with 2 cameras allows a stereoscopic view.
Fig 3
Fig 3
Optics are placed in the central portal. (LD, latissimus dorsi; TM, teres major.)
Fig 4
Fig 4
With optics within the central portal, the latissimus dorsi (LD) is released. (TM, teres major.)
Fig 5
Fig 5
Optics within central portal showing radial nerve (A), teres major insertion (B), and retracted latissimus dorsi (C).
Fig 6
Fig 6
Optics within central portal showing latissimus dorsi (LD), long head of triceps (TLH), and teres major (TM).
Fig 7
Fig 7
The patient is in the ventral decubitus position; the shoulder and scapular area are exposed. (A) Polyester guidewire through deltoid approach. (B) Gastric forceps. (C) Wires where latissimus dorsi was sutured. (D) Polyester guidewire exit.
Fig 8
Fig 8
The patient is in the ventral decubitus position; the shoulder and scapular area are exposed. (A) The latissimus dorsi is sutured with suture anchor wires. (B) The other parts of the suture anchor wires are shown; these will pull the tendon to the humeral head.
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