Background/Objectives: Robotic breast reconstruction is an innovative surgical technique that integrates robotic technology into breast reconstruction procedures, offering several advantages over conventional approaches. These benefits include enhanced visualization, increased surgical dexterity, and superior cosmetic outcomes. This study aims to comprehensively compare robotic-assisted and conventional breast reconstruction approaches in terms of complication profiles and operation-related measurements. Methods: A comprehensive search was conducted in PubMed, Embase, Scopus, Web of Science, Google Scholar, CENTRAL, and VHL from inception to October 2024 to identify relevant studies. Risk ratios for the following complications were calculated between the groups: donor site seroma, hematoma, infection, and unplanned reoperation. Mean differences were also calculated for the duration of surgery, length of postoperative hospital stays, and opioid use. Results: A meta-analysis was performed on 9 studies including a total of 1094 patients. No significant differences were found between the groups in the risk ratios for reoperation, seroma formation, delayed healing, infections, and hematomas. Similarly, there were no significant differences in postoperative opioid use. The duration of surgery was longer in the robot-assisted reconstruction group, whereas the duration of hospital stay was shorter compared to the conventional group. Meta-regression analysis for the duration of surgery model showed that none of the moderators had a statistically significant effect on this outcome. ROBINS-I assessment indicated that all the included studies had a serious risk of bias. Conclusions: Our results suggest that using a robot-assisted approach is associated with a shorter duration of hospital stay and a longer duration of surgery.

Background: Chronic postamputation pain—phantom limb pain (PLP) and residual limb pain—is a major barrier to rehabilitation, with symptomatic neuroma formation a key peripheral contributor. The regenerative peripheral nerve interface (RPNI) provides a physiologic target for transected nerves. This review evaluated the effect of prophylactic RPNI, performed at the time of amputation, on pain-related outcomes. Methods: PubMed, Cochrane CENTRAL, ScienceDirect, SpringerLink, and MinhaBVS were searched through 23 November 2025 for comparative studies of prophylactic RPNI versus standard nerve management in major limb amputation. Primary outcomes were symptomatic neuroma incidence and PLP; chronic opioid use was a secondary outcome. Dichotomous outcomes were pooled using random-effects risk ratios (RR); for outcomes with zero events in one arm, the fixed-effect Peto odds ratio (OR) was used as the primary estimate. Risk of bias was assessed with ROBINS-I and certainty with GRADE. Results: Five comparative cohort studies (238 patients) were included; the primary pooled outcomes were derived from three of these cohorts (symptomatic neuroma, 196 patients; phantom limb pain, 181 patients), with two further studies contributing supportive descriptive data. Prophylactic RPNI markedly reduced symptomatic neuroma formation (0/97 vs. 20/99; Peto OR 0.11, 95% CI 0.05–0.29; p < 0.001; I² = 0%) and PLP (RR 0.52, 95% CI 0.40–0.69; p < 0.001; I² = 0%). Chronic opioid use at 12 months was also reduced (Peto OR 0.12, 95% CI 0.05–0.29; p < 0.001). Findings were consistent across pediatric, dysvascular, and oncologic populations. Certainty was low to very low. Conclusions: Prophylactic RPNI is associated with substantial, consistent reductions in symptomatic neuroma, phantom limb pain, and chronic opioid use after limb amputation. Despite reliance on low-certainty observational data, these consistent findings suggest that prophylactic RPNI may be a useful component of active nerve management; confirmation in prospective, adequately powered comparative studies is required.

Background: Fascicular turnover flap (FTF) is a donor-sparing option for segmental facial nerve repair. This study compared autologous nerve grafting with proximally based and distally based FTF in a rat facial nerve model. Methods: Adult male Wistar rats were randomized to autograft, proximal FTF, or distal FTF (n = 8 per group). A single additional animal with an untreated defect served as a qualitative histological reference. The prespecified primary endpoint was whisker motion amplitude at week 8; the secondary endpoints were central section histomorphometry (nerve tissue area, µm²) and variability metrics (IQR, SD, and coefficient of variation) as measures of reproducibility. Non-parametric tests (Kruskal–Wallis; Mann–Whitney U) were used; pairwise functional comparisons were Holm-corrected; and effect sizes were expressed as Cliff’s δ. Results: At week 8, the overall functional comparison was significant (Kruskal–Wallis p = 0.047), but no pairwise contrast remained significant after Holm correction. Functional recovery was highest in the autograft group, followed by proximal FTF and distal FTF. Both FTF groups showed lower inter-animal variability than autograft for the week-8 functional endpoint, with the distal FTF showing the lowest dispersion. Central section nerve area comparisons did not reach global significance; effect sizes and descriptive statistics favored autograft, and a single unadjusted pairwise contrast (autograft > proximal FTF) should be interpreted cautiously. Conclusions: Both FTF configurations achieved measurable functional and structural regeneration while avoiding an additional free donor nerve graft. Within an 8-week window, autograft remained the benchmark. Between FTF variants, distal FTF produced more stable functional outcomes, but this did not translate into superior functional recovery. Confirmation in larger, balanced cohorts with longer follow-up and vascular/neural labeling is warranted.