Skip Navigation LinksHome > June 2012 - Volume 129 - Issue 6 > Robotic Latissimus Dorsi Muscle Harvest: A Case Series
Plastic & Reconstructive Surgery:
doi: 10.1097/PRS.0b013e31824ecc0b
Reconstructive: Trunk: Original Articles

Robotic Latissimus Dorsi Muscle Harvest: A Case Series

Selber, Jesse C. M.D., M.P.H.; Baumann, Donald P. M.D.; Holsinger, F. Chistopher M.D.

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Abstract

Background: The latissimus dorsi muscle is a workhorse of reconstructive surgery. Traditional harvest technique requires a long, posterior donor-site incision. Endoscopic harvest is limited by technical challenges. Robotic technology permits a simpler, minimally invasive harvest technique.

Methods: Seven consecutive robotic latissimus dorsi muscle harvests were performed by a single surgeon. Two were used as free flaps for scalp reconstruction and the remaining five as pedicled flaps for breast reconstruction; three were for immediate, implant-based reconstruction with nipple-areola complex–sparing mastectomies, and two were for radiated breasts when the expander was exchanged for an implant. Harvest technique employed a short, axillary incision for pedicle dissection and two to three additional ports for robotic instrumentation.

Results: All seven muscle flaps were harvested without converting to an open technique. Both free flaps were successfully transferred. All pedicled flaps resulted in successful breast reconstructions. Flap harvest complications included a single, temporary radial nerve palsy in the contralateral extremity, likely from positioning. There were no donor-site hematomas, seromas, or cutaneous thermal injuries. Robotic harvest time decreased from over 2 hours to about an hour over the study period.

Conclusions: Robotic harvest of the latissimus dorsi is a novel and effective method of muscle harvest. It offers technical advantages over endoscopic harvest and aesthetic advantages over the open technique.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

©2012American Society of Plastic Surgeons

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