ArticlePlastic and reconstructive surgery. Global open2026
Comparison of Robotic-assisted and Conventional Deep Inferior Epigastric Perforator Flaps: A Retrospective Cohort Study.
Article in Plastic and reconstructive surgery. Global open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Background: The deep inferior epigastric perforator (DIEP) flap is widely regarded as the gold standard for breast reconstruction. Recent advancements in robotic-assisted microsurgery have enabled perforator-to-perforator anastomoses. This study aimed to evaluate the conventional technique against the robotic-assisted approach, and the perforator-to-perforator method, to determine its noninferiority. Methods: Sixty-eight patients undergoing breast reconstruction with a DIEP flap between 2022 and 2024 were included. Primary exposure was classified according to the surgical technique used: conventional surgery without the Symani Surgical System, robotic-assisted microsurgery with conventional vessel anastomosis, and robotic-assisted perforator-to-perforator anastomosis. This study investigated outcomes such as surgical complications, hospital length of stay, and postoperative pain medication. Results: Twelve (17.6%) patients underwent robotic-assisted perforator-to-perforator anastomoses, 28 (41.2%) underwent robotic-assisted conventional microsurgical anastomosis, and 28 (41.2%) underwent nonrobotic microsurgical anastomosis. Patient demographics were well balanced across surgical methods. Overall, surgical complications were observed in 25% of patients, with no significant difference in complication rates between perforator-to-perforator anastomoses and conventional anastomoses ( Conclusions: This study demonstrated that robotic-assisted perforator-to-perforator anastomosis in DIEP flap breast reconstruction resulted in a significant reduction in postoperative analgesic pain medication and showed similar complication rates in comparison to conventional anastomosis.
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