Robotic surgery in plastic surgery: a review of its potential

"Background: Robotic surgery currently offers a number of benefits in specific areas of plastic and reconstructive surgery such as head and neck and microsurgery, however, many subspecialties are yet to benefit from robotic operating techniques. In this paper we review recent developments in the use of robotics for head and neck, breast reconstruction, microneural, lymphoedema, craniofacial and aesthetic surgery. Methods: A literature review of English-only articles on the use of robots in plastic and reconstructive surgery was conducted using the PubMed and Web of Science databases along with a free text search using the terms ‘robotic surgery plastic surgery’, ‘robotic-assisted plastic surgery’, ‘robot-assisted reconstructive surgery’, ‘da Vinci plastic surgery’, ‘da Vinci reconstructive surgery’ and ‘supermicrosurgery’. No limitation was placed on time from publication. Results: Of the studies reviewed, the most beneficial to reconstructive surgery is the area of the head and neck, with the most common procedures being transoral surgeries and microvascular procedures. Robotic assisted breast reconstructive surgery is a promising field. The main current limitations are the lack of adequate microsurgical instrumentation and the prolonged setting-up and operative time. Conclusion: As technology improves the outlook for robotic surgery is optimistic. Areas like microsurgery, head and neck, cleft palate, breast reconstructive surgery, lymphatic and microneural surgery already demonstrate promising results. Further technological advances and evidence-based studies are necessary to address current limitations such as appropriate microsurgical instrumentation, high costs and prolonged operative time."