LI Hospital Performs First Robotic DIEP Flap Breast Reconstruction

GLEN COVE, NY — In a first for Long Island, surgeons at Glen Cove Hospital were able to perform a cutting-edge breast reconstruction procedure using a robot.

A deep inferior epigastric artery perforator flap (DIEP) surgery, as the procedure is called, uses a woman's own tissue to create a new breast after a mastectomy. At Glen Cove Hospital, surgeons used the da Vinci robot to remove fatty tissue from the lower abdomen to create a new breast, without ruining the abdominal muscle. It's a procedure that medical experts say is a major step forward in the treatment of women recovering from breast cancer.

Dr. Neil Tanna, vice president of the Katz Women's Surgical Center at Glen Cove, said this technique will become the "gold standard" for such procedures. The catalyst for performing this procedure on Long Island was his patient, Mary Leonardi, who told him that robotic reconstruction was the way she wanted to go.

Because of her strong family history with cancer, Leonardi underwent genetic testing in 2007 and was diagnosed with Lynch Syndrome, a genetic disorder that results in a predisposition for many types of cancer.

"After surviving thyroid cancer and a preventative hysterectomy," Leonardi said, "I made the very difficult decision to undergo a double mastectomy in January of this year. As it turned out, that surgery revealed the presence of pre-cancerous cells."

When it came time to consider breast reconstruction surgery, Leonardi consulted with her plastic surgeon, Dr. Tanna.

"From the beginning, Mary made it very clear that she wanted to have reconstruction using her own stomach tissue (and not implants) through the robotic DIEP flap technique," Dr. Tanna said in a statement.

"The robotic DIEP technique is the most cutting-edge approach to breast reconstruction surgery because it allows for the clean removal of a 'flap' of complete belly fat tissue — including the vital blood vessels — without doing damage to the abdominal wall," he continued. "Also, as we saw with Mary, there's less chance of infection and a quicker rate of recovery."

Since this type of robotic procedure had not been done yet at any Northwell Health hospital, Dr. Tanna contacted his colleague, Dr. Jesse Selber, for assistance.

In addition to pioneering this procedure, Dr. Selber is the director of clinical research and a professor in the plastic surgery department at MD Anderson Cancer Center in Houston, Texas.

On June 7, Dr. Selber traveled to Glen Cove Hospital to help Dr. Tanna and explain the robotic technique. Dr. Tanna and Dr. Selber were also assisted by Dr. Gainosuke Sugiyama, the chair of surgery at Long Island Jewish Valley Stream.

"Doing any surgery for the first time is critical," said Dr. Selber. "Prior to entering the operating room, we went over many of the basic steps. By the time we walked into the room, we were ready. The key to this type of collaboration — especially for the first time — is to control everything you can and to be ready for the unexpected."

After an eight-hour surgery and a two-day hospital stay, Leonardi returned home to her husband of 18 years.

"I'm very proud to have been a part of such a collaborative experience," she said. "Making the robotic procedure available to women in the New York area is so important to me. I want all women to have all the choices — an abundance of choices — when facing this difficult surgery."