Induced Hypothermia: Implications for Free Flap Survival.

comparing the robot-assisted technique with the laparoscopic approach for the RGE-LNF harvest, we noted that the robot-assisted intraperitoneal approach had specific advantages. The three-dimensional optics of the Da Vinci system allowed superior visualization of the anatomy. Accurate bloodless dissection was possible due to the extremely precise platform, tremor elimination, and significant motion scaling. This was particularly important since the RGE-LNF is small, and the robotic intervention allowed preservation of the lymph nodes and the fine lymphatic channels close to the vascular pedicle. In addition, it also aided in the artery and vein dissection before the final flap pedicle division. Robot-assisted harvest of the RGE-LNF is feasible and reproducible. It represents an alternative method for flap harvest and paves the way for use of this approach for harvesting other intra-abdominal organs and tissues for reconstructive surgery. This may prove useful for patients who desire the application of the latest technology and less invasive procedures in their treatment, with the possibility of improved outcomes. It offers technical advantages over endoscopic harvesting and provides better cosmesis when compared to the open surgical technique. Some factors may limit the use of robotic interventions, such as increased cost, a steep learning curve, and increased operating time. However, the distinct advantages of this innovative surgical approach, such as tremor elimination, motion scaling, high-resolution three-dimensional optics, and superior ergonomics, make a compelling case for the expansion of its application in problem-solving specialties, including plastic and reconstructive surgery.