Citation
Frey JD, Yu JW, Cohen SM, Zhao LC, Choi M, Levine JP. Robotically Assisted Omentum Flap Harvest: A Novel, Minimally Invasive Approach for Vascularized Lymph Node Transfer. Plast Reconstr Surg Glob Open. 2020 Apr 24;8(4):e2505
Abstract
The omentum provides abundant lymphatic tissue with reliable vascular anatomy, representing an ideal donor for vascularized lymph node transfer without risk for donor site lymphedema. We describe a novel, robotically assisted approach for omental flap harvest. All patients undergoing robotically assisted omentum harvest for vascularized lymph node transfer from 2017 to 2019 were identified. Patient demographics, intraoperative variables, and postoperative outcomes were reviewed. Five patients underwent robotically assisted omentum flap harvest for vascularized lymph node transfer. The average patient age and body mass index were 51.2 years and 29.80 kg/m2, respectively. Indications for lymph node transfer were upper extremity lymphedema following mastectomy, radiation, and lymphadenectomy (60.0%); congenital unilateral lower extremity lymphedema (20.0%); and bilateral lower extremity/scrotal lymphedema following partial penectomy and bilateral inguinal/pelvic lymphadenectomy (20.0%). Four patients (80.0%) underwent standard robotic harvest, whereas 1 patient underwent single-port robotic harvest. The average number of port sites was 4.4. All patients underwent omentum flap transfer to 2 sites; in 2 cases, the flap was conjoined, and in 3 cases, the flap was segmented. The average overall operative time was 9:19. The average inpatient hospitalization was 5.2 days. Two patients experienced cellulitis, which is resolved with oral antibiotics. There were no major complications. All patients reported subjective improvement in swelling and softness of the affected extremity. The average follow-up was 8.8 months. Robotically assisted omental harvest for vascularized lymph node transfer is a novel, safe, and viable minimally invasive approach offering improved intra-abdominal visibility and maneuverability for flap dissection.
Key Points
- Published in Plastic and reconstructive surgery. Global open in 2020.
- Indexed in PubMed as PMID 32440389.
- Mapped to Robotic & Single-Port, Trauma & Fistula, Outcomes, Methods & Education.
- Abstract available from PubMed and rendered as static text on this page.
Clinical Relevance
This publication is part of the robotic surgery and single-port bibliography, connecting technique development with reconstructive indications and outcome reporting.