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Robot-assisted Nipple-sparing Mastectomy With Immediate Breast Reconstruction: An initial Experience of the Korea Robot-endoscopy Minimal Access Breast Surgery Study Group (KoREa-BSG)

 Jai Min Ryu  ;  Jee Ye Kim  ;  Hee Jun Choi  ;  BeomSeok Ko  ;  Jisun Kim  ;  Jihyoung Cho  ;  Moo Hyun Lee  ;  Jung Eun Choi  ;  Joo Heung Kim  ;  Jeea Lee  ;  Sung Mi Jung  ;  Hyuk Jai Shin  ;  Jeeyeon Lee  ;  Hyung Seok Park 
 ANNALS OF SURGERY, Vol.275(5) : 985-991, 2022-05 
Journal Title
Issue Date
Breast Neoplasms* / pathology ; Breast Neoplasms* / surgery ; Endoscopy / methods ; Female ; Humans ; Male ; Mammaplasty* / methods ; Mastectomy / methods ; Middle Aged ; Nipples / surgery ; Robotics*
Objective: The aim of this study was to present the results of early experience of robot-assisted nipple sparing mastectomy (RANSM).

Background: RANSM improves cosmetic outcomes over conventional nipple-sparing mastectomy. However, data on the feasibility and safety of the RANSM are limited.

Methods: Patients who underwent RANSM with immediate breast reconstruction as part of the Korea Robot-endoscopy Minimal Access Breast Surgery Study Group (KoREa-BSG) from November 2016 to January 2020 were enrolled. clinicopathologic characteristics, perioperative complications, and operation time were collected.

Results: Overall, 73 women underwent 82 RANSM procedures conducted by 11 breast surgeons at 8 institutions. The median patient age was 45.5 years old (20-66 years), and 52 (63.4%) patients were premenopausal. Invasive breast cancer was noted in 55 cases (40 cases were stage i, 11 cases were stage ii, and 4 cases were stage iii, respectively) and ductal carcinoma in-situ was recorded in 20 cases. Of those, 3 patients with BRCA1/2 mutation carriers underwent contralateral risk-reducing RANSM. The median length of hospitalization was 12.0 days (5.0-24.0 days). The incision location was the mid-axillary line and the median incision length was 50.0 mm (30.0-60.0 mm). Median total operation time, median total mastectomy time, and median reconstruction time was 307.0 minutes (163.0-796.0 minutes), 189.5 minutes (97.5-325.0 minutes), and 119.5 minutes (45.0-689.0 minutes). Only 2 cases (2.5%) required reoperation. Nipple ischemia was found in 9 cases (10.9%) but only 1 case (1.2%) required nipple excision given that 8 cases (9.7%) resolved spontaneously. Skin ischemia was observed in 5 cases (6.1%) and only 2 (2.4%) cases needed skin excision whereas 3 cases (3.6%) resolved spontaneously. There was no conversion to open surgery orcases of mortality. The mean time for mastectomy among surgeons who performed more than 10 cases was 182.3 minutes (± 53.7, minutes) and 195.4 minutes (± 50.4, minutes).

Conclusion: This was the first report of RANSM conducted in the KoREa-BSG. RANSM is technically feasible and acceptable with a short learning curve. Further prospective research to evaluate surgical and oncologic outcomes is needed.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Joo Heung(김주흥) ORCID logo https://orcid.org/0000-0002-0417-8434
Kim, Jee Ye(김지예) ORCID logo https://orcid.org/0000-0003-3936-4410
Park, Hyung Seok(박형석) ORCID logo https://orcid.org/0000-0001-5322-6036
Lee, Jeea(이지아) ORCID logo https://orcid.org/0000-0003-3145-2205
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