Robotic surgery: a step further towards the future

The synergy between robots and doctors is longstanding. Robot-assisted surgery is the latest evolution of minimally invasive surgery: in abdominal-pelvic, especially urology and thoracic procedures this advanced technique has helped doctors to reduce the risks associated with conventional surgery and has several advantages for the patient.

Robotic surgery is relatively new to the Senology field.
The IEO Senology Program has been one of the first to use this new approach and since 2014 has been investigating the feasibility and safety of a robot-assisted nipple-sparing mastectomy.

Around 30% of women with breast cancer will undergo a nipple-sparing mastectomy.– says Dr. Antonio Toesca, IEO Team Leader Consultant for the Robotic Breast Surgery Development Project.

Initially the study, conducted in IEO, enrolled patients with high familiar risk of breast cancer or who had tested positive for the BRCA gene mutation who had elected to undergo a risk reducing mastectomy and immediate breast reconstruction.  

Thanks to its minimally invasive approach, the first cases of robotic mastectomy showed encouraging results with regard to cosmetic outcome.

The key strength of this innovative procedure is that only a very small, hidden scar is left and also a significant reduction of post-operative pain and hospitalization period. The highly precise nipple-sparing mastectomy with immediate breast reconstruction, which avoids skin flap necrosis, will significantly reduce the adverse psychological consequences following mastectomy and increase self-esteem.

In addition, this procedure allows a less invasivedissection of the body tissues significantly reducing side effects such as paresthesia and  preserving the sensitive nerves around the nipple areola complex. This will impact on the patient’s quality of life and hence working and social capacity.


How is the study progressing?

After the first positive results with the high-risk patients the decision was made to take the study a step further and offer this new approach to treat patients with breast cancer requiring a nipple-sparing mastectomy. Nipple sparing mastectomy with immediate breast reconstruction will be carried out by minimally invasive robotic surgery in patients with breast cancer who are not eligible for breast conservative surgery.

The end point is to investigate the feasibility, safety, advantages and limitations of the minimally invasive technique for oncoplastic breast surgery.

The treatment for breast cancer continues to improve through findings from new surgical techniques trials. Clinical surgical trials test the benefits of new treatments and risk-lowering strategies: and the goal is to make this new minimal invasive breast surgery part of the standard breast cancer care to tailor and personalize the treatment based on patients’ needs. This precision surgery personalized on the patient’s need gives us one of the greatest opportunities for new medical breakthroughs.

This exceptionally innovative procedure will reduce as much as possible the patient’s discomfort.


For more information please refer to the following study:

Robotic Nipple-sparing Mastectomy and Immediate Breast Reconstruction With Implant: First Report of Surgical Technique. Author: Dr. Toesca Antonio et al. Annals of Surgery. 



Università degli Studi di Milano


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