The importance of rehabilitation, ie the creation of a new breast after mastectomy has been shown extensively in the medical literature since now i know this through beyond psychology, self-confidence and overall quality of life for women, and even improves the prognosis of cancer breast. How is breast reconstruction? There are various recovery techniques during breast used either silicone implants or autologous tissue (ie tissue from the body of the patient) or some combination of both techniques.
One of the most popular techniques is that which uses the latissimus dorsi muscle which is the big broad back muscles. When this technique is first preparation (i.e., detachment) of muscle from the chest wall and the subcutaneous tissue and then transferred to the muscle forward in the breast area in order to create new breast. Given however that the access via the mastectomy incision does not allow us to detachment sufficient anatomical area of the muscle, the predominant choice we had so far was to make an incision in the back but which is usually large, strong leaves unsightly scar and causes severe pain, increased likelihood of inflammation, an important collection and liquid recovery and prolonged hospitalization. What changes with minimally invasive method; Previously attempts have been made use of laparoscopic (endoscopic) tools for detachment of the muscle, but which have not been successful because they have the ability to move only in one axis, and not have access to the wide and narrow cavity muscle is a difficult anatomic area accessible.
The robotic technique allows the preparation (detachment) of the muscle through one centimeter incisions. Developed at MD Anderson cancer center where U.S. used the last 2-3 years. It has the following advantages: a) three-dimensional view of the surgical field and magnified visualization of vascular muscle of nutrients that must be maintained b) polyaxial motion of the robotic instruments that have accessibility so awkward anatomical areas c) tracking precision tools with detail tenths of a millimeter . d) almost completely bloodless detachment of muscle. With this method, we now minimize postoperative pain, less blood loss, to reduce the likelihood of inflammation, faster recovery with a shorter hospitalization and quicker return to normal activities.
Prerequisite for the safe and effective application of this technique is the availability of skilled and properly trained surgeon and surgical team. The procedure is performed by the surgeon as the robotic system is essentially a tool that offers the surgeon excellent access to minimally invasive manner. With proper training, the robotic system is simple to use. It consists of the console where the surgeon sits with the controls in the hands and feet and the base system with robotic arms that perform surgery with the surgeon’s instructions. whether they will affect the cost of rehabilitation? hospitalization time of patients restricted significantly ( 5 days reduced to about 1 or 2 days), almost completely eliminating the additional cost of using the robotic system and the total cost of hospital care is generally the same. Which other applications of that muscle and the robotic system in plastic surgery? The latissimus dorsi muscle is used very often in plastic surgery and repairs deficits in other anatomical regions such as the head, the neck or legs. In these cases, a connection of the vessels of the muscle with blood vessels in the region where it is delivered to the muscle microsurgical techniques connecting vessels. The deficits arising after tumor resections or trauma and the latissimus dorsi muscle covered areas vital as the brain, lungs, bones or large vessels legs etc.
The application of the robot has been extended to other muscle groups detachment such example of the rectus abdominis muscle, which also often used for different restorations deficits. Finally it has started to have clinical application in robotics microsurgical vascular connection, which I made in animal tissues in the laboratory and is admittedly much easier and faster. For these applications we need more research data to be applied to patients. Which approach to new technologies? For robotic system that applies applies to all new technologies that while we must be modest and cautious with new technologies, on the other need to know how and when to evaluate the medical literature. We had no reason to wait any longer to apply the specific medical development in our country.
During all interventions failed reconstruction using all the principles of cosmetic surgery of the breasts applicable to growth, recovery or degrading breast surgery. Patient First Cosmetic breast surgery rehabilitation after mastectomy using the DaVinci robotic surgical system was in 26 year old patient who had undergone mastectomy and radiation. When surgery is transferred latissimus dorsi muscle from the back to the breast by using two smaller incisions of one centimeter on the back. The robotic part of the surgery lasted less than two hours and took place without presenting blood loss. The patient was discharged from the hospital the day after that surgery after postoperatively showed minimal postoperative pain and no problem.