{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T11:20:19Z","timestamp":1762946419075,"version":"3.45.0"},"reference-count":17,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Objective: The omentum is a highly vascularized and immunologically active tissue with significant regenerative potential. Despite its versatility, its use has traditionally been limited to intra-abdominal applications due to access challenges. Conventional open harvest requires laparotomy, and laparoscopic techniques are hindered by limited visualization and poor ergonomics. We describe the use of robotic-assisted omental flap harvest for thoracic reconstruction, offering a minimally invasive alternative. Methods: A retrospective review was conducted of patients who underwent robotic omental flap harvest for intrathoracic reconstruction at a single-center institution between January 2023 and January 2024. Data collected included demographics, indications, surgical technique, operative details, and postoperative outcomes, with a focus on flap viability and complications. Additionally, a systematic review was conducted to evaluate current evidence and experiences with this type of technique. Results: Three patients underwent robotic omental flap harvest for indications including chest wall reconstruction and pleural space obliteration in infected thoracic cavities. The average robotic flap harvest time was 79 \u00b1 13 min, with an estimated \u00b1 blood loss of 20 cc. The mean postoperative hospital stay was 10 days, influenced by the primary procedure and patient comorbidities. At an average follow-up of 8 months, all flaps remained viable, with no flap-related complications or losses. The systematic review demonstrated limited data in the current literature regarding this type of surgical approach. Conclusions: Robotic-assisted omental flap harvest is a safe, feasible, and effective technique for complex thoracic reconstructions. It provides a minimally invasive alternative to traditional harvest methods, with reduced morbidity and excellent clinical outcomes. This technique expands the reconstructive options for intrathoracic defects and infections.<\/jats:p>","DOI":"10.3390\/medsci13040264","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T10:56:47Z","timestamp":1762945007000},"page":"264","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Robotic Omental Flap Harvest for Complex Thoracic Defects: Case Series and Review of the Literature"],"prefix":"10.3390","volume":"13","author":[{"given":"Susana","family":"Fortich","sequence":"first","affiliation":[{"name":"Department of General Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6125-6825","authenticated-orcid":false,"given":"Camila","family":"Franco-Mesa","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Den","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4203-3890","authenticated-orcid":false,"given":"Gabriel","family":"De La Cruz Ku","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University of Massachusetts, Worcester, MA 01605, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gal","family":"Levy","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery, Howard University, Washington, DC 20060, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8730-2930","authenticated-orcid":false,"given":"Roman","family":"Petrov","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.reth.2019.07.008","article-title":"Omentum a powerful biological source in regenerative surgery","volume":"11","year":"2019","journal-title":"Regen. Ther."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1055\/s-0037-1608008","article-title":"The Omental Free Flap-A Review of Usage and Physiology","volume":"34","author":"Mazzaferro","year":"2018","journal-title":"J. Reconstr. Microsurg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e2505","DOI":"10.1097\/GOX.0000000000002505","article-title":"Robotically Assisted Omentum Flap Harvest: A Novel, Minimally Invasive Approach for Vascularized Lymph Node Transfer","volume":"8","author":"Frey","year":"2020","journal-title":"Plast. Reconstr. Surg. Glob. Open"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/s00276-017-1951-7","article-title":"Surgical anatomy of the right gastro-omental artery: A study on 100 cadaver dissections","volume":"40","author":"Settembre","year":"2018","journal-title":"Surg. Radiol. Anat."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.2147\/TCRM.S134869","article-title":"Omentum flap as a salvage procedure in deep sternal wound infection","volume":"13","author":"Spindler","year":"2017","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s00268-022-06783-8","article-title":"Postoperative Complications and Outcome After Emergency Laparotomy: A Retrospective Study","volume":"47","author":"Ylimartimo","year":"2023","journal-title":"World J. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"K\u00f6ckerling, F. (2014). Robotic vs. Standard Laparoscopic Technique\u2014What is Better?. Front. Surg., 1.","DOI":"10.3389\/fsurg.2014.00015"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e1230","DOI":"10.1002\/cl2.1230","article-title":"PRISMA2020: An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis","volume":"18","author":"Haddaway","year":"2022","journal-title":"Campbell Syst. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s11701-019-00949-8","article-title":"Robotic harvesting of the omental flap: A case report and mini-review of the use of robots in reconstructive surgery","volume":"13","year":"2019","journal-title":"J. Robot. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e237887","DOI":"10.1136\/bcr-2020-237887","article-title":"Robotic omental flap harvest for near-total anterior chest wall coverage: A potential application of robotic techniques in plastic and reconstructive surgery","volume":"14","author":"Day","year":"2021","journal-title":"BMJ Case Rep."},{"key":"ref_11","first-page":"15","article-title":"The use of the great omentum in the surgery of breast cancer","volume":"71","author":"Kiricuta","year":"1963","journal-title":"Presse Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"41","DOI":"10.21037\/shc-21-8","article-title":"Complex anterior chest wall reconstruction after extensive oncologic resections: A narrative review","volume":"5","author":"Gritsiuta","year":"2021","journal-title":"Shanghai Chest"},{"key":"ref_13","first-page":"317","article-title":"Laparoscopic Harvest of Omental Flaps for Reconstruction of Complex Mediastinal Wounds","volume":"7","author":"Salameh","year":"2003","journal-title":"J. Soc. Laparoendosc. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.jfma.2012.12.016","article-title":"Chemical pleurodesis for prolonged postoperative air leak in primary spontaneous pneumothorax","volume":"113","author":"How","year":"2014","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.rmed.2018.03.017","article-title":"Persistent air leak\u2014Review","volume":"137","author":"Sakata","year":"2018","journal-title":"Respir. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1055\/s-0031-1275168","article-title":"Overview and Management of Sternal Wound Infection","volume":"25","author":"Singh","year":"2011","journal-title":"Semin. Plast. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1097\/SAP.0b013e318054718e","article-title":"Use of the Greater Omentum for Reconstruction of Infected Sternotomy Wounds: A Prognostic Indicator","volume":"60","author":"Ghazi","year":"2008","journal-title":"Ann. Plast. Surg."}],"container-title":["Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3271\/13\/4\/264\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T11:16:21Z","timestamp":1762946181000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3271\/13\/4\/264"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,12]]},"references-count":17,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["medsci13040264"],"URL":"https:\/\/doi.org\/10.3390\/medsci13040264","relation":{},"ISSN":["2076-3271"],"issn-type":[{"value":"2076-3271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,12]]}}}