Hung-Wen Lai1,2,3,4,5,6, Antonio Toesca6, Benjamin Sarfati7, Hyung Seok Park8, Gilles Houvenaeghel9, Jesse C Selber10, Fiona Tsui-Fen Cheng11, Wen-Ling Kuo12,13, Nickolas Peradze6, Seung Yong Song14, Chi Wei Mok15,16. 1. Endoscopic & Oncoplastic Breast Surgery Center, Changhua Christian Hospital, Changhua, Taiwan. 2. Minimal Invasive Surgery Research Center, Changhua Christian Hospital, Changhua, Taiwan. 3. Kaohsiung Medical University, Kaohsiung, Taiwan. 4. School of Medicine, National Yang Ming University, Taipei, Taiwan. 5. Division of General Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. 6. Division of Breast Surgery, European Institute of Oncology IRCCS, Milan, Italy. 7. Department of Plastic Surgery, Gustave Roussy, France. 8. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. 9. Department of Surgical Oncology, Institut Paoli Calmettes and CRCM and Aix-Marseille Université, Marseille, France. 10. Department of Plastic Surgery, The University of Texas, MD Anderson Cancer Center, Houston. 11. Breast Cancer Center, Shin Kong Wu Ho-Su Memorial Hospital, Taiwan. 12. Division of Breast Surgery and General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan. 13. Chang Gung University College of Medicine, Taoyuan City, Taiwan. 14. Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea. 15. Division of Breast Surgery, Department of Surgery, Changi General Hospital, Singapore. 16. Singhealth Duke-NUS Breast Centre, Singapore.
Abstract
OBJECTIVES: To achieve a consensus statement on robotic mastectomy. BACKGROUND: Robotic-assisted surgery has gained much attention especially the results of few case series reporting on the technical feasibility, safety and early oncologic outcomes of robotic-assisted mastectomy in a few centers worldwide. The aim of this consensus statement was to develop and provide standardized guidelines on robotic mastectomy based on consensus statement by a panel of experts from indications to outcome measures and indicators, thereby providing a valuable guide for breast surgeons worldwide. METHODOLOGY: An internationally representative expert panel of 10 surgeons was invited to participate in the generation of a consensus statement. 52 statements were created in 6 domains: indications, contraindications, technical considerations, patient counseling, outcome measures and indicators, training and learning curve assessment. Experts were asked to vote if they agree, disagree or of the opinion that the statement should be rephrased. Two electronic rounds via online survey of iterative rating and feedback were anonymously completed, followed by a final round of in-person meeting during the inaugural International Endoscopic and Robotic Breast Surgery Symposium 2019 from May 24 to 25, 2019. Consensus was reached when there was at least 80% agreement on each statement. RESULTS: A total of 53 statements with at least 80% agreement were generated after 3 rounds of voting; 21 statements from first round of voting, 20 statements from second round of voting and 12 statements from the final round of in-person meeting. All experts agreed that the consensus statement served as expert recommendations but not mandatory for a successful and safe practice of robotic mastectomy. CONCLUSION: Robotic mastectomy is a promising technique and could well be the future of minimally invasive breast surgery whereas proving to be safe and feasible. The first consensus statement on robotic mastectomy from an international panel of experts serves as an extremely important milestone and provides recommendations for breast surgeons keen to embark on this technique.
OBJECTIVES: To achieve a consensus statement on robotic mastectomy. BACKGROUND: Robotic-assisted surgery has gained much attention especially the results of few case series reporting on the technical feasibility, safety and early oncologic outcomes of robotic-assisted mastectomy in a few centers worldwide. The aim of this consensus statement was to develop and provide standardized guidelines on robotic mastectomy based on consensus statement by a panel of experts from indications to outcome measures and indicators, thereby providing a valuable guide for breast surgeons worldwide. METHODOLOGY: An internationally representative expert panel of 10 surgeons was invited to participate in the generation of a consensus statement. 52 statements were created in 6 domains: indications, contraindications, technical considerations, patient counseling, outcome measures and indicators, training and learning curve assessment. Experts were asked to vote if they agree, disagree or of the opinion that the statement should be rephrased. Two electronic rounds via online survey of iterative rating and feedback were anonymously completed, followed by a final round of in-person meeting during the inaugural International Endoscopic and Robotic Breast Surgery Symposium 2019 from May 24 to 25, 2019. Consensus was reached when there was at least 80% agreement on each statement. RESULTS: A total of 53 statements with at least 80% agreement were generated after 3 rounds of voting; 21 statements from first round of voting, 20 statements from second round of voting and 12 statements from the final round of in-person meeting. All experts agreed that the consensus statement served as expert recommendations but not mandatory for a successful and safe practice of robotic mastectomy. CONCLUSION: Robotic mastectomy is a promising technique and could well be the future of minimally invasive breast surgery whereas proving to be safe and feasible. The first consensus statement on robotic mastectomy from an international panel of experts serves as an extremely important milestone and provides recommendations for breast surgeons keen to embark on this technique.
Authors: Olivia Quilichini; Julien Barrou; Marie Bannier; Sandrine Rua; Aurore Van Troy; Laura Sabiani; Eric Lambaudie; Monique Cohen; Gilles Houvenaeghel Journal: Ann Med Surg (Lond) Date: 2020-12-31