{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:49:06Z","timestamp":1788878946985,"version":"build-2803163510"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"name":"Intuitive Surgical, Inc., Sunnyvale, CA, USA"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Robotic Surg"],"DOI":"10.1007\/s11701-026-03221-y","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T03:33:26Z","timestamp":1771212806000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Robotic breast surgery with and without tunneling using the tumescent technique"],"prefix":"10.1007","volume":"20","author":[{"given":"Yung-Huyn","family":"Hwang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ee Jin","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chae Woon","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung Bae","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Ho","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Sup","family":"Eom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae-Kyung","family":"Yoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jisun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Il-Yong","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beom Seok","family":"Ko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hee Jeong","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong Won","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byung Ho","family":"Son","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3370-6937","authenticated-orcid":false,"given":"Sae Byul","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"3221_CR1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2023.1193486","volume":"10","author":"J Walshaw","year":"2023","unstructured":"Walshaw J, Huo B, McClean A, Gajos S, Kwan JY, Tomlinson J, Biyani CS, Dimashki S, Chetter I, Yiasemidou M (2023) Innovation in gastrointestinal surgery: the evolution of minimally invasive surgery\u2014a narrative review. Front Surg 10:1193486","journal-title":"Front Surg"},{"key":"3221_CR2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-050173","volume":"11","author":"KU Park","year":"2021","unstructured":"Park KU, Lee S, Sarna A, Chetta M, Schulz S, Agnese D, Grignol V, Carson WE, Skoracki RJ (2021) Prospective pilot study protocol evaluating the safety and feasibility of robot-assisted nipple-sparing mastectomy (RNSM). BMJ Open 11:e050173","journal-title":"BMJ Open"},{"key":"3221_CR3","unstructured":"Carson W (2020) Prospective Pilot Study of Robot-assisted Nipple Sparing Mastectomy (RNSM). https:\/\/www.clinicaltrials.gov\/study\/NCT04537312#more-information. Accessed August, 26 2025"},{"key":"3221_CR4","unstructured":"Intuitive Surgical (2023) Robotic vs. Open NSM for Early Stage Breast Cancer (SP NSM). https:\/\/clinicaltrials.gov\/study\/NCT05720039. Accessed August 26 2025"},{"key":"3221_CR5","doi-asserted-by":"publisher","first-page":"3849","DOI":"10.1245\/s10434-018-6759-0","volume":"25","author":"V Galimberti","year":"2018","unstructured":"Galimberti V, Morigi C, Bagnardi V, Corso G, Vicini E, Fontana SKR, Naninato P, Ratini S, Magnoni F, Toesca A (2018) Oncological outcomes of nipple-sparing mastectomy: a single-center experience of 1989 patients. Ann Surg Oncol 25:3849\u20133857","journal-title":"Ann Surg Oncol"},{"key":"3221_CR6","doi-asserted-by":"publisher","first-page":"3046","DOI":"10.1245\/s10434-019-07590-7","volume":"26","author":"A Toesca","year":"2019","unstructured":"Toesca A, Invento A, Massari G, Girardi A, Peradze N, Lissidini G, Sangalli C, Maisonneuve P, Manconi A, Gottardi A (2019) Update on the feasibility and progress on robotic breast surgery. Ann Surg Oncol 26:3046","journal-title":"Ann Surg Oncol"},{"key":"3221_CR7","doi-asserted-by":"publisher","first-page":"1321","DOI":"10.1097\/00006534-199612000-00048","volume":"98","author":"RG Worland","year":"1996","unstructured":"Worland RG (1996) Expanded utilization of the tumescent technique for mastectomy. Plast Reconstr Surg 98:1321","journal-title":"Plast Reconstr Surg"},{"key":"3221_CR8","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1016\/j.amjsurg.2009.12.011","volume":"201","author":"YS Chun","year":"2011","unstructured":"Chun YS, Verma K, Rosen H, Lipsitz SR, Breuing K, Guo L, Golshan M, Grigorian N, Eriksson E (2011) Use of tumescent mastectomy technique as a risk factor for native breast skin flap necrosis following immediate breast reconstruction. Am J Surg 201:160\u2013165","journal-title":"Am J Surg"},{"key":"3221_CR9","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.648955","volume":"11","author":"Y Yang","year":"2022","unstructured":"Yang Y, Zhu J, Qian X, Feng J, Sun F (2022) Complication differences between the tumescent and non-tumescent dissection techniques for mastectomy: a meta-analysis. Front Oncol 11:648955","journal-title":"Front Oncol"},{"key":"3221_CR10","doi-asserted-by":"publisher","first-page":"1606","DOI":"10.1016\/j.jhsa.2015.03.034","volume":"40","author":"MM Bashir","year":"2015","unstructured":"Bashir MM, Qayyum R, Saleem MH, Siddique K, Khan FA (2015) Effect of time interval between tumescent local anesthesia infiltration and start of surgery on operative field visibility in hand surgery without tourniquet. J Hand Surg 40:1606\u20131609","journal-title":"J Hand Surg"},{"key":"3221_CR11","doi-asserted-by":"publisher","first-page":"8","DOI":"10.4174\/astr.2024.107.1.8","volume":"107","author":"Y-H Hwang","year":"2024","unstructured":"Hwang Y-H, Han HH, Eom JS, Yoo T-K, Kim J, Chung IY, Ko B, Kim HJ, Lee JW, Son BH (2024) Evaluation of safety and operative time in tumescent-free robotic nipple-sparing mastectomy: a retrospective single-center cohort study. Ann Surg Treat Res 107:8\u201315","journal-title":"Ann Surg Treat Res"},{"key":"3221_CR12","doi-asserted-by":"crossref","unstructured":"Gwark S, Hwang Y-H, Paek SH, Lee Y-W, Chang YW, Choi HJ, Ahn SG, Park HS, Kim JH, Choi JE (2025) Early postoperative outcomes of Tumescent-Free Single-Port Robot-Assisted Nipple-Sparing mastectomy compared with Tumescent-Using technique: A substudy of retrospective multicenter study (SPROUT, KoREa-BSG 14). Ann Surg Oncol 32:9787\u25009797","DOI":"10.1245\/s10434-025-18041-x"},{"key":"3221_CR13","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","volume":"240","author":"D Dindo","year":"2004","unstructured":"Dindo D, Demartines N, Clavien P-A (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205\u2013213","journal-title":"Ann Surg"},{"key":"3221_CR14","doi-asserted-by":"publisher","first-page":"2607","DOI":"10.1245\/s10434-012-2304-8","volume":"19","author":"AM Abbott","year":"2012","unstructured":"Abbott AM, Miller BT, Tuttle TM (2012) Outcomes after tumescence technique versus electrocautery mastectomy. Ann Surg Oncol 19:2607\u20132611","journal-title":"Ann Surg Oncol"},{"key":"3221_CR15","doi-asserted-by":"publisher","first-page":"4144","DOI":"10.1016\/j.bjps.2022.08.006","volume":"75","author":"CL Nguyen","year":"2022","unstructured":"Nguyen CL, Tam SKM, Easwaralingam N, Seah JL, Comerford AP, Yu ACX, Mak C, Pulitano C, Warrier SK (2022) Patterns of ischaemia and reperfusion in nipple-sparing mastectomy reconstruction with indocyanine green angiography. J Plast Reconstr Aesthet Surg 75:4144\u20134151","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"3221_CR16","doi-asserted-by":"publisher","DOI":"10.2307\/2529310","author":"JR Landis","year":"1977","unstructured":"Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics. https:\/\/doi.org\/10.2307\/2529310","journal-title":"Biometrics"},{"key":"3221_CR17","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1002\/jso.26915","volume":"126","author":"J Go","year":"2022","unstructured":"Go J, Ahn JH, Park JM, Choi SB, Lee J, Kim JY, Park HS (2022) Analysis of robot-assisted nipple\u2010sparing mastectomy using the Da Vinci SP system. J Surg Oncol 126:417\u2013424","journal-title":"J Surg Oncol"},{"key":"3221_CR18","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1245\/s10434-018-6704-2","volume":"26","author":"H-W Lai","year":"2019","unstructured":"Lai H-W, Chen S-T, Lin S-L, Chen C-J, Lin Y-L, Pai S-H, Chen D-R, Kuo S-J (2019) Robotic nipple-sparing mastectomy and immediate breast reconstruction with gel implant: technique, preliminary results and patient-reported cosmetic outcome. Ann Surg Oncol 26:42\u201352","journal-title":"Ann Surg Oncol"},{"key":"3221_CR19","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1097\/SLA.0000000000004492","volume":"275","author":"JM Ryu","year":"2022","unstructured":"Ryu JM, Kim JY, Choi HJ, Ko B, Kim J, Cho J, Lee MH, Choi JE, Kim JH, Lee J (2022) Robot-assisted nipple-sparing mastectomy with immediate breast reconstruction: an initial experience of the Korea Robot-Endoscopy minimal access breast surgery study group (KoREa-BSG). Ann Surg 275:985\u2013991","journal-title":"Ann Surg"},{"key":"3221_CR20","doi-asserted-by":"publisher","DOI":"10.21037\/abs-21-4","author":"C Bille","year":"2022","unstructured":"Bille C (2022) Perspectivising tumescent mastectomy: innovation in preserving mastectomy skin flap perfusion\u2014a narrative review. Ann Breast Surg. https:\/\/doi.org\/10.21037\/abs-21-4","journal-title":"Ann Breast Surg"},{"key":"3221_CR21","doi-asserted-by":"publisher","first-page":"3041","DOI":"10.1245\/s10434-011-1913-y","volume":"18","author":"AK Seth","year":"2011","unstructured":"Seth AK, Hirsch EM, Fine NA, Dumanian GA, Mustoe TA, Galiano RD, Hansen NM, Kim JY (2011) Additive risk of tumescent technique in patients undergoing mastectomy with immediate reconstruction. Ann Surg Oncol 18:3041\u20133046","journal-title":"Ann Surg Oncol"}],"container-title":["Journal of Robotic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11701-026-03221-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11701-026-03221-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11701-026-03221-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T16:06:34Z","timestamp":1771430794000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11701-026-03221-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,16]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3221"],"URL":"https:\/\/doi.org\/10.1007\/s11701-026-03221-y","relation":{},"ISSN":["1863-2491"],"issn-type":[{"value":"1863-2491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,16]]},"assertion":[{"value":"14 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was performed in line with the principles of the 1964 Helsinki Declaration and its later amendments. Approval was granted by the Institutional Review Board of Asan Medical Center (IRB) of Asan Medical Center (2022\u2009\u2212\u20090282). Here is the detail regarding to patient data security: As a retrospective study, there are no anticipated clinical risks. However, since the study involves the use of patients\u2019 medical records, there is a potential risk of exposing personal information. To mitigate this, minimizing such risks by encrypting the data and restricting access. The anonymized information obtained from the study subjects will be securely managed using locked or password-protected devices, ensuring that only the research team has access. Additionally, anonymized data will be encrypted using MS Excel or MS Access encryption features, preventing anyone other than the researchers from storing or viewing the data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Due to the retrospective nature of the study, the Institutional Review Board of Asan Medical Center waived the need of obtaining informed consent.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}}],"article-number":"259"}}