Robotic arm preserves nipple in breast-cancer surgery trial

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COLUMBUS, Ohio (WCMH) — When a woman faces the loss of her breast to cancer, keeping the nipple can help to preserve sexual satisfaction and overall well being.

Currently at The James Cancer Hospital a clinical trial is underway to help surgeons perform this technically-difficult operation, says Dr. Ko Un “Clara” Park, Assistant Professor of Surgery at the Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital.

It’s a small trial — only 20 cases — and not every woman will be eligible to participate. But if the robotic surgery system is approved by the FDA following the trial, it will pave the way for many more women to have their nipples preserved when the breast is reconstructed.

The trial, says Dr. Park, will include women with a C-cup or smaller, who have little breast droop — measured in the distance from where an underwire would sit, to the nipple itself, when a woman is sitting upright.

“Not every woman is an appropriate candidate mainly because [they may have] a large tumor, or a tumor involving the nipple,” explained Dr. Park. “The ideal candidates typically have a smaller breast size and do not have droop.

“We are also able to offer this operation to patients who don’t have a tumor, but who are at increased risk due to genetics such as the BRCA mutation, or other family histories.”

In the operation, doctors remove the breast mound but the skin and the nipple are saved. The mound is re-created using an implant, says Dr. Park.

The robotic surgical system allows the surgeon to use small robotic arms and a three-dimensional camera through a console. When the surgeon moves her hands, it moves the robotic arms.

“The console is where the surgeon sits, and basically it has an eyepiece that I look into, and it gives me a 3-dimensional visualization of the surgical field through the camera,” Dr. Park said. “There is a handpiece that I move that is directly connected to the robotic arms.”

The technology, called the da Vinci surgical system, isn’t new. The robotic arms are used in cardiac, prostate, colorectal, and general surgery, and the system’s been in development since 1995.

“The expectation [is] that the FDA will take this information and re-consider the use of robots in nipple-sparing mastectomy, at which point other surgeons would be able to perform this operation as well,” said Dr. Park.

Studies comparing the full removal of the nipple with nipple-saving surgery show that sexual satisfaction is higher in women who can keep their nipples, said Dr. Park.

Participating in the trial will cost the same as breast cancer surgery, and the recovery times are also about the same — four to six weeks. Interested patients can contact The James Cancer Patient Line and schedule an appointment at  614-293-5066.

Copyright 2021 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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