17: Prospective Pilot Study of First in Human Use of Single Port Robotic Platform in Nipple Sparing Mastectomy

Saturday, March 12, 2022

9:24 AM – 9:32 AM CST

Location: Chantilly East

Abstract Presenter(s)

Deborah E. Farr, MD

Associate Professor
UT Southwestern Medical Center
Dallas, Texas, United States

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Participants should be aware of the following financial/non-financial relationships:

Deborah E. Farr, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Introduction: Robotic assisted nipple sparing mastectomy (rNSM) utilizing a multi-port, multi-arm robotic platform was first described in 2015. Single port (SP) robotic platforms were developed in 2018 to allow increased operative visibility and range and motion. The aim of this study is to describe the operative set up, feasibility and outcomes in the initial cohort of patients undergoing single port robotic nipple sparing mastectomy (SPrNSM) with immediate tissue expander reconstruction.

Methods: As part of an IRB approved, prospective registry trial, an initial series of 10 patients underwent bilateral SPrNSM with pre-pectoral tissue expander reconstruction from February 2020 to July 2021. Inclusion criteria included candidates for open NSM patients with regard to anatomic factors and tumor location. Data collected included patient age, surgical indication, body mass index, breast size, operative time, conversion to open surgery, margin status, peri-operative adverse events, postoperative skin necrosis, and patient reported nipple sensation.

Results:

As shown in Table 1, ten women (median age 40, range 35-63 years) underwent SPrNSM with immediate tissue expander reconstruction. The most common surgical indication was risk-reducing surgery due to high-risk mutation (6 patients). Breast cup size ranged from A-D cup (median B), with median BMI of 24 (range, 22.1-27.8). Median operative time was 277 minutes (range 219-351) with no conversion to open procedure. In the four patients with breast cancer all final operative margins were negative. There were no intra-operative or 30-day adverse events. Nipple sensation was preserved in 18/20 breasts at 30 days.

Conclusions:

This first in human prospective study of SPrNSM with immediate tissue expander reconstruction demonstrates feasibility and safety in the initial patient experience. This encouraging early experience supports need for larger studies with longer measured oncologic outcomes.

Learning Objectives:

Upon completion, participant will be able to describe the surgical indication of the initial cohort of patients undergoing single port robotic nipple sparing mastectomy with immediate tissue expander reconstruction.
Upon completion, participant will be able to describe the feasibility of the single port robotic nipple sparing mastectomy with immediate tissue expander reconstruction.
Upon completion, participant will be able to describe the outcomes of the initial cohort of patients undergoing single port robotic nipple sparing mastectomy with immediate tissue expander reconstruction.