Single-incision robotic nipple-sparing mastectomy with immediate breast reconstruction: a comprehensive surgical technique and strategy.

With the increasing application of robotic surgical systems in various surgical fields and the progressive refinement of endoscopic breast surgery, robotic breast surgery has been actively explored and implemented. Robotic surgical platforms offer several advantages, including enhanced flexibility, three-dimensional magnified visualization, high-resolution imaging, and tremor elimination, thereby improving surgical stability and precision, particularly in confined surgical spaces. Given that the breast lacks a natural cavity, robotic surgical systems exhibit a high degree of adaptability for breast surgery. In 2015, Toesca et al. first reported robotic nipple-sparing mastectomy (R-NSM) with immediate breast reconstruction (IBR), which has since become a mainstream approach in robotic-assisted breast surgery. Existing studies have consistently demonstrated that R-NSM with IBR is a safe and feasible procedure, achieving good aesthetic outcomes, high patient satisfaction, and a low complication rate. However, as R-NSM with IBR is still in its nascent stages, particularly, single-incision R-NSM with IBR, the procedure involves intricate and complex surgical steps. The adoption of this novel technology imposes higher requirements on surgical precision, further increasing the procedural complexity. Standardized protocols and systematic workflows for this procedure are yet to be established. In this study, we provide a comprehensive step-by-step description of the entire surgical process of single-incision R-NSM with IBR through an instructional video and text.