title: A novel technique for robot assisted latissimus dorsi flap harvest.
abstract: BACKGROUND
  A robotic surgery technique of harvesting the latissimus dorsi muscle flap has technical advantages over endoscopic harvest and cosmetic advantages over the open technique. The authors introduce a new transaxillary gasless technique using an articulated long retractor for robot assisted latissimus dorsi flap harvest.
  
  
  METHODS
  Twelve robot assisted latissimus dorsi muscle flaps were harvested: 3 cases of delayed reconstruction following tissue expander insertion or breast conserving surgery; 4 cases of immediate reconstruction following nipple-sparing mastectomy; and 5 cases of chest wall deformity correction in patients with Poland syndrome. A specially designed articulated long retractor was used to maintain adequate working space and enable latissimus dorsi muscle dissection without gas insufflation.
  
  
  RESULTS
  Twelve muscle flaps were successfully harvested in 12 patients without converting to an open technique. The mean docking time was 54.6 min, and the mean operative time and robotic time were 400.4 min and 85.8 min, respectively. There were no donor site complications or flap problems. Average follow-up was 15.7 months. All patients were satisfied with their esthetic results, especially the absence of visible scars.
  
  
  CONCLUSIONS
  The novel robot assisted latissimus dorsi harvest technique is a safe alternative to the conventional method.
authors.affiliation: Department of Plastic Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jae-Hyun
authors.initials: JH
authors.lastname: Chung
authors.affiliation: Department of Plastic Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hi-Jin
authors.initials: HJ
authors.lastname: You
authors.affiliation: Department of Plastic Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hyon-Surk
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Plastic Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Byung-Il
authors.initials: BI
authors.lastname: Lee
authors.affiliation: Department of Plastic Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Seung-Ha
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Plastic Surgery, Korea University College of Medicine, Seoul, Republic of Korea. Electronic address: yesanam2@korea.ac.kr.
authors.forename: Eul-Sik
authors.initials: ES
authors.lastname: Yoon
mesh_terms: D000328:Adult; D018427:Breast Implants; D001943:Breast Neoplasms / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D017060:Patient Satisfaction; D011045:Poland Syndrome / Q000601:surgery; D012189:Retrospective Studies; D012371:Robotics / Q000295:instrumentation* / Q000379:methods*; D064171:Superficial Back Muscles / Q000601:surgery*; D013524:Surgical Flaps; D035441:Thoracic Wall / Q000601:surgery; D020858:Tissue and Organ Harvesting / Q000379:methods*; D055815:Young Adult
keywords: Gasless technique; Latissimus dorsi; Robot; da Vinci