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Uniportal Robotic Assisted Mastectomy (U-RABS)
Case description
This video is being presented at the Humans at the Cutting Edge of Robotic Surgery Symposium 2024, Jaipur, India. It was produced by Dr Jagdishwar Goud Gajagowni, Apollo Hospitals, Hyderabad, India.
Abstract: Uniportal Robotic Assisted Mastectomy (U-RABS)
INTRODUCTION We have designed an innovative minimally invasive robotic assisted uniportal mastectomy.We would like to describe our technique with modifications.
BACKGROUND: Nipple & aerola sparing Robotic mastectomy,axillary clearance has a role in select cases.
METHOD and TECHNIQUE: Position” Supine, arm abducted. A 4cms incision is given in midclavicular line, centered at nipple level. A subcutaneous plane is created for few centimetres & a Uniport is inserted. DaVinci Xi camera is inserted through centre R3port, a force bipolar through R2 & Monopolar scissors through R4 are inserted. 2ml patent blue dye in injected 2cms medial to midline.Robot is docked with center beam in line with R2. Dissection is done carefully in a plane between subcutaneous area & breast tissue. Tissue under Nipple aerola complex is sent for frozen section to ensure that there is no tumor. The breast tissue is dissected sequentially from medial to superior side ,inferior side & go on to pectoralis major fascia. The breast is removed from the port & an implant with pre fixed size is inserted subpectorally. Incision is closed with a drain and subcuticular suture.
RESULTS We have done 6 cases with the same technique. The procedure is standardized with clear steps and followed in all cases. Use of force bipolar helps in traction to breast tissue as well as controlling any bleeders
CONCLUSION Uniportal Robotic Assisted Breast Surgery (U-RABS) has emerged as a new treatment option for breast cancer and for risk-reducing mastectomy. We are standardizing the technique.
