Unilateral Multiport Robotic Totally Extraperitoneal Deep Inferior Epigastric Perforator Flap

The deep inferior epigastric perforator (DIEP) flap is considered the gold standard in breast reconstruction. Robotic harvest of the DIEP flap aims to further minimize abdominal morbidity by reducing anterior fascial damage. Most descriptions of robotic DIEP flaps describe transabdominal approaches that require transecting and then repairing the posterior sheath. We describe a unilateral robotic totally extraperitoneal approach using multiple ports that avoids transecting the posterior sheath and entry into the abdomen.