Comparison of Surgical Outcomes in Robot-Assisted Nipple Sparing Mastectomy with Conventional Open Nipple Sparing Mastectomy: A Single Center Experience

<b>Background</b>: A surgical therapy for breast cancer, robot-assisted nipple-sparing mastectomy (RANSM) has gained popularity because it may offer better cosmetic results than traditional nipple-sparing mastectomy (CNSM). Data regarding RANSM's viability and security are still scarce, nevertheless. Comparing the surgical results of RANSM and CNSM in a single-center experience was the goal of this study. <b>Methods</b>: 57 patients who had nipple-sparing mastectomy procedures performed at our facility between January and December 2021 were included in this retrospective research. Of them, 49 patients had CNSM, and 8 patients had RANSM. Analysis was performed on pain scores, length of hospital stay, postoperative complications, patient demographics, and operating time. <b>Results</b>: The mean total operative time was longer for RANSM group was 148 min compared to 117 min for the CNSM group; however, this difference was not statistically significant (<i>p</i> = 0.083). The mean duration of hospital stay was shorter for the RANSM group than for the CNSM group (10.75 days vs. 2.92 days, respectively; <i>p</i> = 0.302). Both groups had similar pain scores on postoperative day 3 (RANSM: 3.50, CNSM: 3.54, <i>p</i> = 0.926). No patient in the RANSM group received adjuvant chemotherapy or radiotherapy, whereas 32.6% of patients in the CNSM group received chemotherapy. The RANSM and CNSM groups experienced complications at rates of 12.5% and 18.4%, respectively (<i>p</i> = 0.571). In contrast to 14.3% in the CNSM group, there were no documented incidences of skin necrosis in the RANSM group. <b>Conclusions</b>: RANSM demonstrated comparable safety to CNSM with potential benefits, including a shorter hospital stay and lower complication rates. These findings support the feasibility of RANSM, particularly in patients prioritizing cosmetic outcomes. To validate these initial findings, more research with larger cohorts and longer follow-up times is necessary.