Robot-Assisted Minimally Invasive Breast Surgery: Recent Evidence with Comparative Clinical Outcomes

Abstract

In recent times, robot-assisted surgery has been prominently gaining pace to minimize overall postsurgical complications with minimal traumatization, due to technical advancements in telerobotics and ergonomics. The aim of this review is to explore the efficiency of robot-assisted systems for executing breast surgeries, including microsurgeries, direct-to-implant breast reconstruction, deep inferior epigastric perforators-based surgery, latissimus dorsi breast reconstruction, and nipple-sparing mastectomy. Robot-assisted surgery systems are efficient due to 3D-based visualization, dexterity, and range of motion while executing breast surgery. The review describes the comparative efficiency of robot-assisted surgery in relation to conventional or open surgery, in terms of clinical outcomes, morbidity rates, and overall postsurgical complication rates. Potential cost-effective barriers and technical skills were also delineated as the major limitations associated with these systems in the clinical sector. Furthermore, instrument articulation of robot-assisted surgical systems (for example, da Vinci systems) can enable high accuracy and precision surgery due to its promising ability to mitigate tremors at the time of surgery, and shortened learning curve, making it more beneficial than other open surgery procedures.

Keywords: ergonomics; open surgery; postsurgical complications; robot-assisted surgery.

Figure 1

Schematic depiction of robot-assisted surgery (example: da Vinci robot-assisted surgical system) equipped with easily maneuverable, flexible, and stable mechanical arms. The implications of the robot-assisted surgery system can assist the surgeon to perform surgery typically with substantial precision and can generate patient-satisfied aesthetic requirements according to the design of incision. Model: the latest da Vinci’s robot-assisted surgery model is “the Si”, released in 2009. It is composed of a master console, a mobile platform, and an operational cart with four arms; Company: Intuitive Surgical Inc., Sunnyvale, CA, USA; Date of image acquisition from the I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya Street, Moscow, 119991, Russia: 29 September 2019.