First in Israel: Mastectomy performed entirely by ‘hands’ of a robot

“This is the next thing for patients who need to undergo a mastectomy,” said Professor Yoav Barnea, head of the unit for Plastic and Reconstructive Breast Surgery at Sourasky. “The robot will allow maximum precision, excellent aesthetic results, including preservation of the original nipple and all in a single surgery instead of at least three separate surgeries in the previous method, and with fast recovery and minimal scarring.”

The surgery is performed using the Da Vinci Surgical System. The surgeon sits at a console and controls the robot.

“The robot is an extension of the surgeon’s hands,” Barnea explained.

A special camera is used to view the inside of the breast, giving the doctor a complete view of what is happening.

Ichilov Hospital and Sourasky Medical Center in Tel Aviv. (credit: WIKIMEDIA COMMONS / GELLERJ)

“It looks really up close,” Barnea said. “It’s like you are inside the chest.”

The surgery was performed in correlation with a visit from Dr. Benjamin Sarfati, who works at a major French hospital, has performed at least 80 of these robotic surgeries there and is helping train the Israeli team. Barnea said the goal is also to be able to perform this robotic surgery regularly in Israel.

Sourasky is not the only hospital with a Da Vinci system, so others might consider this surgery as well.

“Robotic surgery is not something new,” Barnea emphasized. “It is something that is done almost routinely in Israeli hospitals, but for other indications.”

The challenges of a traditional mastectomy are that a large scar is created, he said, and that because the cut is made in the lower part of the breast and worked on the upper part, the surgeon works blindly for at least part of the procedure. . .

In contrast, robotic mastectomy allows for shorter and more hidden scars. It also provides direct vision and therefore improved precision. Breast reconstruction is performed immediately afterwards using the same cuts. And the nipple can be moved and preserved.

The entire surgery takes about an hour and a half to two hours per breast.

However, there are downsides. Barnea said using the robot involves a learning curve and costs more than traditional surgery.

At this stage, the procedure is approved for preventive mastectomies, that is, for women who are prone to breast cancer and choose to be proactive, such as those who carry the BRCA gene. However, Barnea said: “I believe that this innovative method will soon become the surgical routine for hundreds of breast patients in Israel each year.”

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