Annals of Surgical Oncology

, Volume 26, Issue 1, pp 42–52 | Cite as

Robotic Nipple-Sparing Mastectomy and Immediate Breast Reconstruction with Gel Implant: Technique, Preliminary Results and Patient-Reported Cosmetic Outcome

  • Hung-Wen LaiEmail author
  • Shou-Tung Chen
  • Shih-Lung Lin
  • Chih-Jung Chen
  • Ya-Ling Lin
  • Shu-Hsin Pai
  • Dar-Ren Chen
  • Shou-Jen Kuo
Breast Oncology



Experience with application of a robotic surgery platform in the management of breast cancer is limited. The preliminary results of the robotic nipple-sparing mastectomy (R-NSM) and immediate breast reconstruction (IBR) with Gel implant procedure are reported.


The medical records of patients from a single institution who underwent an R-NSM and IBR with Gel implant procedure for breast cancer during the period March 2017 to February 2018 were assessed. Data on clinicopathologic characteristics, type of surgery, complications, and recurrence were analyzed to determine the effectiveness and oncologic safety of R-NSM. Patient-reported cosmetic outcome results were obtained.


A total of 22 patients who received 23 R-NSM and IBR with Gel implant procedures were analyzed. The mean operation time for R-NSM was 118.8 ± 50.6 min, and 74.5 ± 26.6 min for Gel implant reconstruction. Docking time quickly dropped from 20 to 6–8 min, and the time needed to complete R-NSM was usually completed within 100 min after accumulation of case experience. Mean blood loss was 37 ± 38.2 mL, and the positive surgical margin rate was 0%. Three (13%) patients had transit nipple ischemia change, and no total nipple-areolar complex necrosis cases were observed. No local recurrence or mortality was found during a mean 6.9 ± 3.5 months of follow-up. All 22 patients were satisfied with the postoperative aesthetic outcome.


From our preliminary experience, R-NSM and IBR with Gel implant is a safe procedure, with good cosmetic results, and could be a promising new technique for breast cancer patients indicated for mastectomy.



The authors would like thank Yun-Ting Chang and Shun-Ing Tsai for their assistance in this study.


This study was funded by the Ministry of Science and Technology of Taiwan (funding number: MOST 107-2314-B-371-006), and was sponsored by research funding provided by the CCH (104-CCH-ICO-006, 105-CCH-PRJ-003, 105-CCH-IRP-025, and 106-CCH-IRP-015).


Hung-Wen Lai, Shou-Tung Chen, Shih-Lung Lin, Chih-Jung Chen, Ya-Ling Lin, Shu-Hsin Pai, Dar-Ren Chen, and Shou-Jen Kuo have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (MP4 52647 kb)


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Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  1. 1.Endoscopic and Oncoplastic Breast Surgery CenterChanghua Christian HospitalChanghuaTaiwan
  2. 2.Division of General SurgeryChanghua Christian HospitalChanghuaTaiwan
  3. 3.Comprehensive Breast Cancer CenterChanghua Christian HospitalChanghuaTaiwan
  4. 4.School of MedicineNational Yang Ming UniversityTaipeiTaiwan
  5. 5.Division of Breast SurgeryYuanlin Christian HospitalYuanlinTaiwan
  6. 6.Minimally Invasive Surgery Research CenterChanghua Christian HospitalChanghuaTaiwan
  7. 7.Kaohsiung Medical UniversityKaohsiungTaiwan
  8. 8.School of MedicineChung Shan Medical UniversityTaichungTaiwan
  9. 9.Division of Plastic and Reconstructive Surgery, Department of SurgeryChanghua Christian HospitalChanghuaTaiwan
  10. 10.Department of PathologyChanghua Christian HospitalChanghuaTaiwan
  11. 11.Department of Medical TechnologyJen-Teh Junior College of Medicine, Nursing and ManagementMiaoliTaiwan

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