Ultrasound-Guided, Indocyanine Green-Directed Robot-Assisted Breast Surgery for Benign Tumours.

OBJECTIVE: To compare the feasibility, safety, and cosmetic satisfaction of ultrasound-guided, indocyanine green (ICG)-assisted robotic lumpectomy with open lumpectomy for benign breast tumours. STUDY DESIGN: A retrospective cohort study. Place and Duration of the Study: Department of Breast Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China, from June to September 2023. METHODOLOGY: A step-by-step protocol was developed for surgeons to guide ultrasound-guided ICG injections for robotic lumpectomy. Clinicopathological characteristics of the patients, intraoperative data, postoperative complications, and aesthetic outcomes were analysed. Continuous variables were compared using an independent-samples t-test if they were normally distributed; otherwise, the Mann-Whitney U test was used. Categorical variables were compared using a chi-square test or a corrected chi-square test. RESULTS: A total of 68 patients treated concurrently were included in the study; of whom, 30 underwent a robot-assisted local tumour excision through an axillary incision, while 38 had their tumour excision through a standard open incision over the breast. Operation time was significantly longer in the robotic group (96.0 vs. 42.5 minutes; p <0.001). No significant intergroup difference was found in postoperative complications. Patients who underwent robotic surgery achieved significantly higher rates of the highest level of satisfaction with the wound site (96.7% vs. 52.6%; p <0.001), scar appearance (93.3% vs. 71.1%; p = 0.020), and overall breast look (86.7% vs. 60.6%, p = 0.017). CONCLUSION: This surgical approach, using ICG injection and ultrasound guidance, provides a potentially feasible and safe method for tumour localisation during robotic lumpectomy. KEY WORDS: Aesthetic outcome, Breast surgery, Indocyanine green, Robot-assisted surgery, Ultrasound-guidance.