Robot-assisted DIEAP flap harvesting: a review of techniques

Abstract

Robotic surgery has expanded the capabilities of human surgical techniques by offering tremor elimination, ergonomic positioning, 3D viewing, and improved resolution.The purpose of the study: to examine DIEAP flap harvesting techniques using minimally invasive robot-assisted techniques.Material and Methods. The PubMed, SCOPUS, ScienceDirect, and Russian scientific electronic library databases were used for the review; the search was performed using the key phrases robotic deep inferior epigastric artery perforator flap, robotic DEIAP, robotic breast surgery, robot-assisted breast reconstruction. Inclusion criteria: case reports or cadaveric studies.Results. Nine studies were found that met the inclusion parameters. Nine studies looking at DIEAP flap extraction using robot-assisted techniques included a total of 59 patients. Five studies defined the flap harvesting technique as transperitoneal or intraperitoneal. Only 1 study described extroperitoneal flap harvesting. Three studies used the same terminology: transabdominal preperitoneal and total extroperitoneal. A lack of consensus in terminology was found.Conclusion. Robot-assisted DIEAP flap harvesting can be performed using transabdominally preperitoneal and total extraperitoneal techniques, as well as using monoport and multiport accesses with different port locations. However, for a more detailed study, randomized controlled trials with control of anterior abdominal wall weakness and with comparison of complications of different techniques are needed.