Robotic Breast Reconstruction with the Latissimus Dorsi Flap

The recent advent of robotic-assisted technology has allowed for significant advances in minimally invasive surgery, essentially freeing physicians from the physical limitations of their own hands. Robotic-assisted surgery has successfully integrated into urology, surgical oncology, gynecology, and thoracic surgery, but plastic surgical indications remain a relatively novel frontier. For two-stage, delayed-immediate reconstruction of the breast, robotic-assisted latissimus dorsi harvest (RALDH) is an excellent option for patients who wish to avoid a traditional latissimus dorsi donor-site incision. In this chapter, we review indications for robotic-assisted surgery in breast reconstruction, pertinent anatomy, patient selection, technique, and institutional outcomes. Robotic-assisted harvest of the latissimus dorsi muscle is associated with a low complication rate and reliable results for delayed reconstruction of the irradiated breast, and for the properly selected patient eliminates the need for a donor-site incision.