Application of modified spiral tracheoplasty in thyroid carcinoma with trachea invasion: a retrospective analysis of 15 cases.

BACKGROUND: To describe the indications, techniques and preliminary experience of modified spiral tracheoplasty in the reconstruction of large tracheal defect after thyroidectomy. METHODS: The medical records of patients who underwent tracheal torsion to repair large tracheal defects after thyroid carcinoma surgery from January 2019 to January 2022 were retrospectively reviewed. The extent of tracheal defect, duration of tracheal reconstruction, postoperative complications and surgery results were analyzed. RESULTS: The duration of tracheal reconstruction was 30-60 min. No postoperative bleeding, incision infection, tracheostomy stenosis occurred. Recurrent laryngeal nerve palsy occurred in 5 patients. All patients were followed up for 24 to 60 months. The 2-year overall survival rate was 100%, the 2-year local control rate of trachea was 100%, and the 2-year tumor-free survival rate was 81.8%. CONCLUSION: The modified spiral tracheoplasty is a safe and effective method to repair the large defect of trachea after thyroid carcinoma invading the trachea.

Simple and Safe Soft-Tissue Coverage Technique Using the Bipedicled Flap in the Lower Leg.

Background: Skin and soft-tissue defects in the lower legs present significant challenges for surgeons, especially when tendons, bones, or implants are exposed. In such cases, simple dressings or skin grafts are insufficient, necessitating flap surgery. The bipedicled flap is a simpler and more reliable method with a high success rate compared to other flaps, showing minimal flap failures. This study aimed to examine the advantages and limitations of using a bipedicled flap for soft-tissue reconstruction in the lower legs. Methods: This retrospective study reviewed medical records from January 2013 to May 2020, involving 10 bipedicled flaps performed on the lower legs. The study included 5 male and 5 female patients, with an average age of 54.5 years. The defects were due to various causes, including trauma, tumor surgery, postoperative complications such as dehiscence and skin necrosis, and chronic osteomyelitis. The size of the defects ranged from 4 × 3 cm to 16 × 13 cm. The outcomes assessed included flap viability, postoperative complications, and patient satisfaction. Patient satisfaction was assessed on a 15-point scale, evaluating appearance, function, and sensation with up to 5 points each, and categorizing scores as poor (1-3), below average (4-6), average (7-9), good (10-12), and excellent (13-15). Results: All flaps were successfully performed, and there were no cases showing any special complications. Patient satisfaction following the operation was excellent in 3 patients, good in 6 patients, and average in 1 patient, with an overall average score of 11.5 (good) out of 15 among the 10 patients evaluated. Conclusions: The bipedicled flap is a simple and secure method for treating soft-tissue defects in the lower legs. Therefore, this technique can be considered as one of the viable options for treating such defects.

Dorsal Scapholunate Ligament Complex Reconstruction Using Suture Tape-Augmented Autologous Free Tendon Graft for Chronic Scapholunate Dissociation.

Background: The treatment of chronic scapholunate dissociation (SLD) can be challenging due to several factors such as poor quality of ligament, malalignment of the carpus, limited surgical options, and risk of recurrent instability. Various surgical techniques have been developed, but there is ongoing debate regarding the optimal surgical technique. This study aimed to report the clinical and radiological outcomes after dorsal scapholunate (SL) ligament complex reconstruction using suture tape-augmented autologous tendon graft. Methods: The study included patients with Garcia-Elias stage 3-4 chronic SLD, SL advanced collapse (SLAC) stage 1, and a follow-up period exceeding 1 year. Pre- and postoperative SL gap, SL angle (SLA), radiolunate angle (RLA), and dorsal scaphoid translation (DST) were measured, and wrist active range of motion, Modified Mayo Wrist Score (MMWS), and visual analog scale (VAS) were evaluated. Results: Nine patients were included in this study with a mean follow-up period of 17 months (range, 15-31 months). All patients were male, with a mean age of 49 years (range, 30-62 years). Eight patients were classified as Garcia-Elias stage 4, while one was classified as SLAC 1. The median (range) of preoperative, immediate postoperative, and final follow-up measurements for SL gap, SLA, RLA, and DST were 5.4 mm (4.5-5.9), 2.1 mm (1.8-2.5), and 2.5 mm (2.0-2.8) (p = 0.008); 76° (69°-88°), 50° (32°-56°), and 54° (50°-64°) (p = 0.008); 22° (11.5°-33°), 2.8° (0.5°-3.8°), and 3.8° (2.2°-5.6°) (p = 0.008); and 2.8 mm (2.0-3.4), 0.8 mm (0.1-1.2), and 1.0 mm (0.1-2.0) (p = 0.008), respectively. Immediately after surgery, all radiological measurements showed significant improvement, which persisted up to 15 months postoperatively. The preoperative and final follow-up measurements of active flexion, extension, radial deviation, and ulnar deviation of the wrist showed significant improvement. The median preoperative and final follow-up values of MMWS were 51.1 (range, 40-60) and 88.3 (range, 85-95) (p = 0.007), respectively, and those of VAS were 7 (range, 6-8) and 2 (range, 1-3) (p = 0.007), respectively. Conclusions: Dorsal SL ligament complex reconstruction using suture tape-augmented autologous free tendon graft could be regarded as a feasible and straightforward technique for addressing irreparable chronic SLD.

Palatal relaxing incisions versus nasopharyngeal relaxing incisions in Palatoplasty.

BACKGROUND: Bone denudation after conventional relaxing incisions could be a critical factor in inhibiting maxillofacial growth. To address this, alternative relaxing incisions were designed. Thus, this study aimed to compare the effectiveness of palatal relaxing incisions versus nasopharyngeal relaxing incisions in enhancing postoperative outcomes. MATERIALS AND METHODS: A retrospective cohort study was conducted, involving a total of 120 patients divided into three groups: 40 patients have received modified Furlow palatoplasty with nasopharyngeal relaxing incisions (M.F + N.P.I palatoplasty), and 40 patients who received modified Furlow palatoplasty with palatal relaxing incisions (M.F + P.R.I palatoplasty). The other 40 patients received original Furlow palatoplasty without relaxing incisions (F palatoplasty). Data collected included gender, cleft type, cleft width, age at repair, velopharyngeal function, presence of palatal fistula, and follow-up. The chi-square test compared frequencies of sex, cleft type, postoperative fistula, and velopharyngeal outcomes across groups. The Mann-Whitney and independent t-tests compared mean values, with statistical significance set at p < 0.05. RESULTS: The mean age at repair was similar across groups, with follow-up periods ranging from 5 to 11 years. No significant differences were found among the M.F + N.P.I and M.F + P.L.I groups regarding gender, cleft type, cleft width, and age at repair. However, the F group had a significantly narrowest cleft width compared to the other groups. Postoperative outcomes showed no significant differences in velopharyngeal function among the three groups, but the F group had a significantly higher rate of palatal fistula (32.5%) compared to the M.F + P.L.I (10%) and M.F + N.P.I (7.5%) groups. A comparison of the two modified Furlow techniques revealed no significant differences in velopharyngeal closure rates or the incidence of velopharyngeal insufficiency and persistent palatal fistula across different Veau classifications. CONCLUSIONS: While both incisions showed similar impacts on palatoplasty outcomes, palatal relaxing incisions may expose more bone and pose a higher risk of secondary healing issues. Therefore, nasopharyngeal relaxing incisions are recommended as an effective and potentially preferable technique in palatoplasty whenever feasible. CLINICAL RELEVANCE: The current study suggests that, whenever feasible, nasopharyngeal relaxing incisions are advised as an effective and potentially superior technique in palatoplasty.

Results of innervated digital artery perforator flap and direct-flow homodigital flap application in fingertip soft tissue amputations.

OBJECTIVE: The purpose of this study is to compare the results of the innervated digital artery perforator (IDAP) flap and the direct-flow homodigital flap as reconstruction methods for fingertip soft tissue amputations. This issue is important in hand surgery, and we aim to identify the method that provides the best functional and cosmetic outcomes. METHODS: Between 2020 and 2022, 32 patients with fingertip amputations were reconstructed by the same surgeon using two different methods. The patients were retrospectively divided into two groups: those who underwent IDAP (n = 14) and those who had a direct-flow homodigital flap (n = 18). We compared the groups in terms of defect size, cold intolerance, venous congestion, Sollerman hand function test scores, Seddon sensory test scores, and follow-up periods, as well as flap viability, flexion contracture, and static two-point discrimination (s2PD). RESULTS: Of the 32 patients (26 men, 6 females; age: mean 28.72 ± 11.5 years), the injuries were caused by different mechanisms, including sharp (57.1% IDAP), crush (75% IDAP) and entanglement (66.7% homodigital). The average area of tissue loss was approximately 2.70 ± 1.37 cm², while the average s2PD measurement was approximately 4.94 ± 1.04 mm. Postoperatively, the Seddon sensory test results for the homodigital flap group were S4 (61.5%), S3 (23.1%), S3+ (7.7%), and S2 (7.7%), compared to the IDAP group, which showed S4 (57.9%), S3+ (21.1%), and S3 (21.1%). Complications occurred in five patients, though no flap loss or revision was required. The postoperative mean Sollerman hand function scores were higher for the homodigital group than for the IDAP group, with values of 75 ± 2.64 and 73 ± 3.34, respectively. Although not statistically significant, the results numerically suggest that the IDAP flap is better in terms of sensory recovery and hand function compared to the homodigital flap (p > 0.05). CONCLUSIONS: This is the first investigation to compare direct-flow flaps with IDAP. The average follow-up period for patients who underwent homodigital surgery was also shorter than that of the IDAP group. Furthermore, the mean postoperative two-point discrimination and postoperative Sollerman function score were higher in patients who had homodigital surgery.

"Revolutionizing retrosigmoid surgical precision: AI in free bone flap reconstruction".

Free bone flap reconstruction is essential to the retrosigmoid method of microvascular decompression (MVD) and can completely transform surgical methods worldwide. According to studies like Liao et al. (2023), 92.3% of patients report feeling better after receiving treatment. The study by Shize Li et al. emphasizes the affordability and accessibility of free bone flap reconstruction, demonstrating shorter recovery times, lower expenses, and similar rates of complications to those of conventional fixation techniques. With benefits like fewer headaches and a quicker recovery in the free bone flap group, their retrospective analysis of 189 patients showed no significant differences in hospital stay or complication rates between the fixed and unfixed bone flap groups.Despite these results, larger sample sizes and longer-term studies are needed to confirm these findings and address issues such as leakage of cerebrospinal fluid. Furthermore, adding Artificial Intelligence (AI) to this method may improve accuracy and results. AI has the potential to enhance MVD procedures and patient outcomes through its capacity to create 3D models, direct bone flap placement, and track postoperative progress. Standardizing AI's application in clinical practice still presents difficulties, though. In the end, even though Shize Li et al.'s research significantly advances the body of knowledge already in existence, more creativity and investigation are required to maximize free bone flap reconstruction in MVD.

[Preparation of vascularized forearm dermal fat flap and repairing of donor site].

Objective:This study prepared vascularized dermal fat flaps and introduced a local split-thickness skin graft from an in situ cutaneous area cutaneous area to manage forearm flap donor sites and evaluated the esthetic and functional outcomes post-operatively. From July 2020 to June 2023, 13 patients with soft tissue defects in Oral and Maxillary Area were repaired with tvascular forearm dermal fat flap. There were 8 males and 5 females, aged from 42-71 years. The flaps ranged from 8 cm×7 cm to 7 cm×5 cm in size. The donor site defects were covered by local split-thickness skin graft from the in situ skins. The color matching degree, surgical scars, ranges of wrist movement and hand sensations in donor forearms were assessed at 6 months after surgery. Results:The tvascular forearm dermal fat flaps for 15 cases all survived. All the local split-thickness skin grafts transplanted with this technique showed primary healing. The follow-up period for 6 months, Donor site exhibited suitabler color matching and there was not severe complications. Conclusion:The vascularized dermal fat flap provides an alternative to conventional forearm flap harvest, which enables primary donor site closure with reduced rates of delayed donor site healing. The vascularized dermal fat flap is a relatively reliable repair method for soft defects in Oral and Maxillary Area.

Versatility in the use of cadaveric skin grafts for wound management.

BACKGROUND: Cadaveric skin grafts were initially used for the management of acute burn wounds. The biological coverage of the wound improves the quality of the wound bed, which prepares it to receive an autologous skin graft. The benefits of cadaveric skin graft in burn wounds have led to its use in the management of acute and chronic wounds of diverse etiologies. OBJECTIVE: To evaluate the use of cadaveric skin graft and subsequent autologous split-thickness skin graft (STSG) in the management of wounds of diverse etiologies at a single institution. MATERIALS AND METHODS: A retrospective analysis was performed of patients with wounds of different etiologies managed with cadaveric skin grafts followed by a second procedure in which autologous STSG was performed from May 2017 through May 2022 in the Plastic and Reconstructive Surgery Department of German Hospital, Buenos Aires, Argentina. RESULTS: A total of 25 patients with wounds of different etiologies were included. The mean affected body surface area (BSA) was 1.87%. The mean engraftment percentage of the cadaveric skin graft was 96.6%. The mean engraftment percentage of the STSG was 90.6%. All patients demonstrated improvement in local edema and inflammation, reduced secretions, and reduced pain after treatment. Two patients (8%) had complications, with 1 case of delayed healing of the donor site and 1 case of hypertrophic scarring. CONCLUSIONS: Cadaveric skin graft with subsequent STSG is a simple, safe, and effective alternative for the management of complex wounds of diverse etiologies. This technique is particularly useful in patients with multiple comorbidities who are at risk of recurrence and of developing multiple wounds during their lifetime.

Clinical effects of different types of flaps selected according to local conditions in the treatment of diabetic foot defects.

BACKGROUND: The repair of diabetic foot defects (DFD) is a major challenge in clinical practice. The purpose of this study was to investigate the difference in clinical efficacy of different flap techniques in repairing DFD wounds, and to compare the difference in clinical efficacy of anterolateral thigh perforator flap (ALTP) in repairing DFD and non-DFD. METHODS: This study is a retrospective clinical study of different types of flap reconstruction in patients with DFD admitted to our hospital from January 2010 to December 2021. A total of 40 patients with DFD and 43 patients with non-DFD were included in this study. Detailed preoperative basic information, intraoperative details, postoperative complications and long-term follow-up results were collected. RESULT: The comorbidities, wound infection and wound duration of DFD group were more serious than those of non-DFD group. In addition, the incidence of complications was higher in DFD group, the wound healing time was longer, the aesthetic evaluation, the functional recovery rate of ankle joint and the sensory recovery effect of flaps were worse. CONCLUSION: In this study, it is concluded that different flap techniques can obtain better clinical efficacy in repairing DFD wounds. Compared with non-DFD wounds, the postoperative risk of DFD wounds using free ALTP flaps is higher, but the risk can be reduced by reasonable preoperative vascular examination. Free flap can deal with various irregular wounds and provide more options for clinical repair. LEVEL OF EVIDENCE: III, Case-control study.

Introducing Cloacagram in Israel: Advancing Anatomical Assessment and Surgical Planning for Cloacal Malformations.

BACKGROUND: Cloacal malformation represents the rarest and most complex congenital anorectal malformation in females and is characterized by the convergence of urinary, gynecological, and intestinal systems within a single common channel. Three-dimensional computed tomography reconstruction (3D CT cloacagram) has emerged as a valuable method for anatomical assessment and preoperative planning. OBJECTIVES: To evaluate our experience with 3D CT cloacagram and assess its results. METHODS: This retrospective case series included all patients with cloacal malformation who underwent preoperative 3D CT cloacagram at a single institution during 2019-2023. Collected data included patient characteristics, timing of the 3D CT cloacagram, results of the 3D CT cloacagram, comparison with endoscopic results, surgical procedures, and postoperative outcome. RESULTS: Six patients with cloacal malformation were included in this study, including two with posterior cloaca. The median common channel length on 3D CT cloacagram was 24.5 mm (range 9-48 mm) and the median urethral length was 15.5 mm (range 13-24 mm). The surgical approach involved a combined abdominoperineal approach in three patients and posterior sagittal anorectal vaginal urethral plasty in one patient. Two patients were awaiting surgical reconstruction at the time of publication. CONCLUSIONS: Our implementation of 3D cloacagram has facilitated precise measurements of both the urethra and common channel lengths, two key factors in formulating surgical strategies for cloacal reconstruction. Moreover, this technique has markedly improved our capacity for surgical planning contributing to colorectal, gynecological, and urological perspectives.

Distally based sural flaps for soft tissue defects following traumatic osteomyelitis of lower leg and foot.

This retrospective study aimed to determine the incidence and risk factors for osteomyelitis recurrence and present our experiences in treating traumatic osteomyelitis in the lower leg and foot. We retrospectively reviewed data from 174 patients with distally based sural flaps for treating traumatic osteomyelitis with soft tissue defects in the lower leg and foot from November 2003 to February 2021. Possible risk factors for osteomyelitis recurrence were compared between the osteomyelitis control and recurrence groups. A total of 162 (93.1%) flaps survived uneventfully, while 12 (6.9%) flaps developed partial necrosis. Five patients had a bone defect with an average length of 5 cm. The free vascularized bone grafts were performed in two patients, and bone transportations were performed in three patients. All patients were followed up with an average period of 72.8 months. There were 152 patients (87.4%) in control group and 22 patients (12.6%) in recurrence group. The recurrence rates of osteomyelitis were significantly higher when the patient's age was 40 years or more and the duration was 10 weeks or more (P < 0.05). Cierny-Mader (C-M) classification type IV osteomyelitis was also significantly associated with osteomyelitis recurrence (p = 0.049). This flap combined with appropriate osteomyelitis treatment was an effective method to treat traumatic osteomyelitis of lower leg and foot with a soft tissue defect. Both patient age ≥ 40 years old and C-M type IV osteomyelitis were nonnegligible risk factors for osteomyelitis recurrence.

Full Thickness, Near-Total to Total Lower Lip Reconstruction Using Superficial Circumflex Iliac Artery Perforator Free Flap: A Case Report.

Near-total to total lower lip defects present significant challenges for reconstructive surgeons, requiring restoration of oral competency, maximization of oral aperture, and cosmetic appearance. This report explores a novel reconstructive option addressing all three needs. Traditionally, local flap options restore cosmesis and oral competency by recruiting local tissue of similar thickness, pliability, and appearance, but often result in microstomia. Conversely, free flaps prevent microstomia but can lead to bulky and cosmetically unacceptable reconstructions. We present the first case of using a super-thin superficial circumflex iliac artery perforator (SCIP) free flap for near-total, full-thickness lower lip reconstruction. The patient was a 66-year-old female with recurrent squamous cell carcinoma of the lower lip, requiring wide local excision and resulting in an 80% full-thickness defect with unilateral oral commissure loss. An 8 cm × 5 cm × 5 mm SCIP flap was raised with a 4.5-cm pedicle length and anastomosed to the facial artery and vein. Clear fluids were commenced 7 days postoperatively, wounds healed 2 weeks postoperatively, and a normal diet was resumed at this time. The SCIP flap offers an excellent additional option for managing full-thickness near-total to total lower lip defects. Its thin, pliable nature and minimal donor site morbidity help restore oral competency, maximize oral aperture, and achieve a pleasing cosmetic result.

Three-dimensional printed titanium chest wall reconstruction for tumor removal in the sternal region.

Resection of thoracic wall tumors results in significant defects in the chest wall, leading to various complications. In recent years, the use of three-dimensional (3D) printed titanium alloy prostheses in clinical practice has demonstrated enhanced outcomes in chest wall reconstruction surgery. A cohort of seven patients with sternal tumors was identified for this study. Following a helical CT scan, a digital model was generated for the design of the prosthesis. Subsequently, the tumors were then removed together with the affected sternum and ribs. The chest wall was then reconstructed using 3D-printed titanium alloy prosthesis for bone reconstruction, mesh for pleural reconstruction, and flap for soft tissue reconstruction. Patients were monitored for a period of one year post-surgery. In the seven cases examined, the tumors were found in various locations with varying degrees of invasion. Based on the scope of surgical resection and the size of the defect, 3D-printed titanium alloy prosthesis was custom-designed for chest wall reconstruction. Prior to bone reconstruction, pleural reconstruction was achieved with Bard Composix E/X Mesh, while soft tissue repair involved muscle flap and musculocutaneous flap procedures. A one-year follow-up assessment revealed that the utilization of the 3D-printed titanium alloy prosthesis led to secure fixation, favorable histocompatibility, and enhanced lung function. The findings demonstrate that the utilization of 3D printed titanium alloy prostheses represents a significant advancement in the field of chest wall reconstruction and thoracic surgical procedures.

The Metabolic Effects and Effectiveness of the Different Reconstruction Methods used in Gastric Cancer Surgery: A Systematic Review and Meta-Analysis.

Gastric Cancer (GC) is the fifth most common cancer worldwide. Early stages of GC began being detected, giving rise to a new concern, Quality of Life. This study aimed to systematically assess the effects of different GC reconstruction techniques on postoperative type 2 diabetes mellitus (T2DM), hypertension (HBP), and body mass index (BMI) reduction rate and to provide an overview of recent research on oncometabolic surgery (OS). We performed a systematic review and meta-analysis by searching three databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We performed a meta-analysis of risk ratios and mean differences to estimate the impact of duodenal bypass, Roux-en-Y reconstruction, and residual stomach on T2DM, HBP, and BMI reduction rate. Heterogeneity was assessed using the I2 statistics. At the end of the follow-up, the duodenal bypass group compared to Billroth I had a significantly higher postoperative remission of T2DM and HBP, with a relative risk (RR) of 1.43 (95% confidence interval (95% CI) [1.27; 1.62]) and 1.3 (95% CI [1.00; 1.69]), respectively. Compared with the Billroth II group, Roux-en-Y reconstruction had significantly greater T2DM remission after gastrectomy (RR = 1.19; 95% CI [1.08; 1.31]), while HBP showed no significant differences. Regarding the improvement of HBP, total gastrectomy was significantly superior to subtotal gastrectomy (95% CI [1.01; 2.64]). A trend towards Roux-en-Y Esophagojejunostomy as the best option for T2DM remission was observed (95% CI [0.98; 2.77]; p = 0.06). Gastrectomy with Roux-en-Y reconstruction appears to be the most effective treatment for T2DM remission. Further research is needed to assess the impact of OS on metabolic diseases.

Facial reconstruction with thinned anterolateral thigh free flap.

Facial reconstruction is challenging for plastic surgeons, as it can be difficult to decide the best approach. One technique that has been widely used is the anterolateral thigh (ALT) flap due to its numerous benefits. However, its thickness can be a drawback, especially regarding facial reconstruction. The thinning technique is not a new novel, but how to apply it to the ALT flap to get the best result hasn't been reported yet. Our study involved 117 patients, and we used 73 thinned ALT flaps to determine the best method to increase the flap's safety. After thinning, we significantly reduced the flap's thickness from an average of 22.5 mm to 5.9 mm, making it more suitable for contouring purposes. We apply a thinned ALT flap for coverage, contouring, and recreating the facial 3D structure. The 12/45 flap has the chance to make the multiple-paddle ALT flap, which helps to reconstruct difficult positions even more flexibly. The key to successfully thinning the ALT flap is understanding the perforator's structure and pathway through the fascia. With the thinning technique, we have overcome the limitations of the flap's thickness, making it suitable for use in whole-body reconstruction. The ALT flap can overcome the restriction of its thickness and can be applied even more extensively in whole-body reconstruction.

Head and neck free flap reconstruction under the COVID-19 pandemic.

High perioperative mortality and complication rates during the coronavirus disease 2019 (COVID-19) pandemic have been reported. In head and neck reconstruction, not only is patient safety important, but the prevention of infection introduced by the surgical team is also important because the procedure is performed in close proximity to the upper respiratory tract. In addition, recent studies have reported an increased risk for thrombus formation after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 vaccination, which is problematic for microsurgical reconstruction procedures. At the authors' institution, patients undergoing head and neck reconstruction are requested to stay home for 2 weeks and undergo screening tests for COVID-19 before admission. Surgeons use standard personal protective equipment during surgery. There was no significant difference in the rate of total flap necrosis between the COVID-19 and non-pandemic periods or large difference of perioperative complication rates between vaccinated and non-vaccinated patients. No surgery-related infections among the surgical staff were also found.

Surgical Strategies and Perioperative Outcomes of Robot-Assisted Vena Cava Reconstruction.

BACKGROUND: This study aimed to describe robot-assisted vena cava reconstruction by summarising surgical strategies and perioperative outcomes. METHODS: A retrospective review was performed on all robotic surgeries involving dissection and repair of the inferior vena cava (IVC) at our institution. Patient characteristics, operative reports, and follow-up visits were analysed. RESULTS: Thirty-nine patients underwent robot assisted surgery of the vena cava from 2016 to 2023. The median postoperative hospital stay of all patients was 7 days, and the median estimated blood loss (EBL) was 550 mL. The median IVC clamping time was 23 min, and IVC wall invasion was pathologically identified in five cases. No patients had liver or kidney dysfunction at the last follow-up. CONCLUSION: Our initial experiences demonstrate that it is safe and feasible for experienced surgeons to perform robot-assisted vena cava reconstruction in highly selected patients.