Minimally invasive harvest of the latissimus dorsi flap for breast reconstruction: A systematic review

Escandón J.M.; Nazerali R.; Ciudad P.; Lo Torto F.; Maruccia M.; Butterfield J.A.; Vizcay M.; Galán N.; Manrique O.J. · International Journal of Medical Robotics and Computer Assisted Surgery (2022) · DOI: 10.1002/rcs.2446

Resumen

Background: Poor cosmetic results with oncoplastic and implant-based breast reconstruction have stimulated an interest in latissimus dorsi flap (LDF)-based reconstruction. We reviewed the surgical techniques and outcomes of the LDF harvested with minimally invasive surgery. Methods: A systematic search was conducted across PubMed-MEDLINE, Web of Science, Scopus, and Ovid-MEDLINE(R). Data on surgical outcomes were extracted. Results: 31 articles were included reporting on 857 reconstructive procedures using a LDF harvested, 497 were endoscopic-assisted LDF (EALDF) (58%) and 174 were robotic-assisted LDF (RALDF) (20.3%). The average flap harvest time was 84.04-min for EALDF and 106.14-min for RALDF. With an EALDF, the incidence of haematoma, seroma, and wound dehiscence ranged between 0%–16.6%, 0%–48%, and 0%–6.2%, respectively. Using RALDF, the incidence of seroma was between 0%–26.1% and 0%–3.4% for haematoma. Conclusions: While the indications for a LDF harvested with MIS are limited, its main advantage for breast reconstruction is the absence of the back scar.