Robot-assisted scaffold implantation and two-stage flap raising of the greater omentum for reconstruction of the facial skeleton: Description of a novel technique

Abstract

Background: Bone regeneration in the greater omentum is a promising strategy in facial skeleton reconstruction. This feasibility-study aims to perform robot-assisted scaffold implantation and second-stage flap raising. Methods: Firstly, scaffolds were implanted into the greater omentum using the da Vinci Xi surgical system or conventional technique in five miniature pigs, respectively. After 3 months a free flap including the gastrocolic vascular pedicle was harvested and procedures were evaluated. Results: The average operation time was 59.2 min for open surgery and 73.8 min for robot-assisted surgery. The average incision length of open surgery was 11.6 cm. Both techniques led to successful scaffold implantation without any complication. In all cases the scaffolds were integrated as intended and resulted in bone formation. Conclusions: Current study demonstrated that the implantation of scaffolds into the greater omentum and flap harvesting using da Vinci Xi surgical system is a promising minimally-invasive approach in regenerative surgery.