In the continuous battle against cancer, the adoption of modern technologies has revolutionized cancer treatments. These advancements have propelled cancer care forward significantly and improved patients’ quality of life. Among these developments, Robotic Nipple – Sparing Mastectomy (RNSM) combined with TiLoop implant reconstruction stands out as a ground – breaking innovation in breast surgery.
The Apollo Cancer Centre (ACC) in Bengaluru successfully carried out India’s first Robotic Nipple – Sparing Mastectomy using Titanised Polypropylene (TPP) Mesh for breast implant reconstruction on a 37 – year – old woman named Latha. She was diagnosed with right – breast cancer in April 2024. Her lump measured 3 cm x 2.5 cm, and the lymph nodes in her axilla were enlarged.
The expert team, led by Dr. Jayanti Thumsi, the Lead & Robotic Breast Surgeon at the Apollo Cancer Centre in Bangalore, gave her 16 cycles of chemotherapy (NACT). She tested negative for the BRCA gene.
In September 2024, the team performed RNSM with TiLoop and breast implant reconstruction. Latha was discharged with a drain, which was removed a week later. Since she was positive for Estrogen Receptor (ER) and Progesterone Receptor (PR) and negative for Human Epidermal Growth Factor Receptor2 (Her2), her tubes and ovaries were also removed. Subsequently, she received radiation therapy, which ended in November 2024. Now, she is on Hormone Therapy and is doing well.
Another cancer survivor, a 48 – year – old woman named Sneha T (name changed), was diagnosed with right – breast cancer in October 2024. She underwent RNSM with TiLoop and implant reconstruction in November 2024.
She had Mucinous carcinoma of the breast and didn’t receive chemo or radiation therapies. Currently, she is on Hormone Therapy and is in good condition.
Sneha T shared her thoughts on the treatment: “I’m glad I made the right decision to undergo RNSM with implant reconstruction using TiLoop Mesh. Initially, I was worried about losing my breast as part of the cancer treatment. Now, I’m extremely satisfied. Not only am I cancer – free, but my breast has been beautifully reconstructed, and the symmetry on both sides has been perfectly maintained.”
Robotic nipple – sparing mastectomy is a minimally – invasive procedure. It aims to remove breast tissue while preserving the skin envelope, the nipple – areola complex (NAC), and the natural breast contours. Performed with the da Vinci Surgical System, this approach gives surgeons enhanced dexterity, precision, and 3D high – definition imaging for detailed dissection. The use of small, hidden incisions ensures minimal visible scarring. This technique offers multiple benefits. It ensures oncological safety through thorough breast – tissue removal, aesthetically preserves the NAC and skin, and reduces trauma, leading to less pain, less blood loss, and a shorter recovery time.
The TiLoop Bra, a titanium – coated polypropylene mesh, is a game – changer in RNSM, improving reconstructive outcomes. Acting as a scaffold, it provides structural support to hold the implant in place, prevents displacement, and promotes seamless tissue integration. Its biocompatible design minimizes the risk of complications like capsular contracture. Also, its ability to enhance symmetry and shape ensures a more natural appearance.
The workflow for this combined procedure starts with preoperative planning. This includes imaging studies and consultations to assess the tumor’s location, size, and the patient’s suitability for RNSM. During the robotic surgery, a small incision is made to precisely remove tissue while preserving the NAC. Then, the TiLoop mesh is placed along with the breast implant to reconstruct the breast. Post – operative care involves monitoring for healing and recovery. Most patients can resume normal activities within a few weeks.
The combined benefits of RNSM and TiLoop reconstruction include a minimally – invasive approach that reduces scarring and recovery time. The preservation of the NAC leads to improved cosmetic results. Patients experience greater comfort due to less post – operative pain, and there is a lower risk of implant – related complications such as migration or contracture.
Traditionally, breast reconstruction in India has mainly used autologous tissue techniques, especially the Latissimus Dorsi (LD) flap. This method involves harvesting tissue from the patient’s back, including the latissimus dorsi muscle, to reconstruct the breast mound. The procedure is complex, with extensive tissue dissection. This leads to longer surgical times, a higher chance of post – operative complications, and a prolonged recovery period.
Dr. Jayanti Thumsi, the Lead Surgeon and Robotic Breast Surgeon at the Apollo Cancer Centre in Bangalore and the first in India to treat 16 women with breast cancer using the TiLoop Mesh, shared her insights: “Robotic nipple – sparing mastectomy with TiLoop implant reconstruction is the perfect combination of precision technology and innovative reconstructive techniques. It provides women with a safer and less – invasive reconstruction option, encouraging more Indian patients to consider reconstruction after mastectomy. This advanced approach not only ensures effective cancer clearance but also preserves a woman’s femininity, significantly enhancing her quality of life after breast – cancer treatment. Ultimately, the goal is to treat the physical disease while also prioritizing the patient’s emotional well – being.”
Mr. Dinesh Madhavan, President of Group Oncology and International at Apollo Hospitals Enterprise Ltd (AHEL), said: “Robotics has transformed cancer care. The implementation of advanced materials and designs, along with the integration of imaging and visualization technologies, has enhanced surgical accuracy and sped up recovery. The use of Titansed Polypropylene Mesh helps with surgical decision – making by improving the recognition of minute and complex anatomical structures. Advancements like Robotic Nipple – Sparing Mastectomy with TiLoop and breast implant reconstruction have led to faster recovery and fewer complications in patients. This shows the continuous pursuit of progress in healthcare.”
Dr. Manish Mattoo, CEO of the Karnataka & Central Region at AHEL, said: “The introduction of TiLoop mesh is likely to address many concerns that have traditionally stopped Indian women from choosing reconstruction. Its minimally – invasive nature, combined with better outcomes and shorter recovery times, makes it an attractive option for patients hesitant about traditional procedures. Moreover, the positive experiences of early adopters can help overcome cultural stigmas and encourage others to consider reconstruction.”
This innovative approach shows the continuous evolution of medical technologies, aiming to improve patient outcomes and experiences in breast – cancer treatment. In India, breast – cancer rates are notably high, especially among young women, accounting for 48% of cases.
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