Robotic nipple-sparing mastectomy for the treatment of breast cancer: Feasibility and safety study.
BACKGROUND
We previously devised and reported on an innovative surgical technique of robotic nipple-sparing mastectomy and immediate robotic breast reconstruction. Here we describe the outcome of the first 29 such consecutive procedures performed on breast cancer patients to assess feasibility, reproducibility and safety.


METHODS
The following morbidity factors were tested: operation time, conversion rate to open technique, length of hospitalization, registration of complications for 1 year postoperatively and their characterization as either minor, major, or multiple, depending on clinical severity and treatment required.


RESULTS
The total duration of the final robotic surgeries of our series was around 3 h, showing a very rapid learning curve. The conversion rate due to technical problems was 2 of the 29 procedures (6,9%). No major complications, including hematoma, seroma, skin or nipple-areola injury or necrosis or infection were observed for any case. Two patients had a small degree of blistering from internal electrocautery in the breast skin flap, both of which resolved in one week without any specific therapy. No systemic complications were observed.


CONCLUSIONS
The low conversion rate to open surgery, the rapid learning curve and the low rate of post-operative complications observed in this preliminary series lead us to endorse a prospective study aimed at evaluating patient satisfaction.
Division of Breast Surgery, European Institute of Oncology, Milan, Italy. Electronic address: antonio.toesca@ieo.it.
Antonio
A
Toesca
Division of Breast Surgery, European Institute of Oncology, Milan, Italy.
Nickolas
N
Peradze
Division of Plastic and Reconstructive Surgery, European Institute of Oncology, Milan, Italy.
Andrea
A
Manconi
Division of Breast Surgery, European Institute of Oncology, Milan, Italy.
Viviana
V
Galimberti
Division of Breast Surgery, European Institute of Oncology, Milan, Italy.
Mattia
M
Intra
Division of Medical Senology, European Institute of Oncology, Milan, Italy.
Marco
M
Colleoni
Division of Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy.
Bernardo
B
Bonanni
Early Drug Development for Innovative Therapies Division, European Institute of Oncology, Milan, Italy.
Giuseppe
G
Curigliano
Division of Plastic and Reconstructive Surgery, European Institute of Oncology, Milan, Italy.
Mario
M
Rietjens
Division of Pathology, European Institute of Oncology, Milan, Italy; University of Milan, School of Medicine, Milan, Italy.
Giuseppe
G
Viale
Division of Breast Surgery, European Institute of Oncology, Milan, Italy; University of Milan, School of Medicine, Milan, Italy.
Virgilio
V
Sacchini
Division of Breast Surgery, European Institute of Oncology, Milan, Italy; University of Milan, School of Medicine, Milan, Italy.
Paolo
P
Veronesi
D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery*; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D016462:Mammaplasty / Q000379:methods*; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D009558:Nipples / Q000601:surgery; D061646:Operative Time; D059351:Organ Sparing Treatments / Q000379:methods; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome
Breast cancer; Breast reconstruction; Conservative mastectomy; Nipple-sparing mastectomy; Risk-reducing surgery; Robotic mastectomy