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Breast endoscopic single-site surgery for nipple-sparing mastectomy in oncological patient

Epublication WebSurg.com, Apr 2012;12(04). URL: http://websurg.com/doi/vd01en3650

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  • 2012-04-16
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Minimally invasive breast surgery has recently been proposed although the optimal technique still has not been determined. We report for the first time the new technique of video-assisted nipple-sparing mastectomy (V-NSM) performed through an axillary single port access with gas flow for breast cancer. The technique was named BESS: breast endoscopic single site surgery. A 3cm skin incision in the axilla was used for all surgical procedures. If indicated, axillary operative steps (sentinel lymph node biopsy, full dissection) were performed under direct vision as well as the preparation of the breast tail. A single port device that can hold up to 3 instruments was then inserted into the axillary incision. Trocars were used for the placement of a 30-degree, 5mm scope and 2 operative instruments. The use of carbon dioxide gas flow allowed for an optimal operative field to easily separate the mammary gland from the superficial skin layer along the stretched Cooper’s ligaments, by using Ultracision 5-plus during the whole endoscopic time.