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. 2014 Feb;24(2):77-82.
doi: 10.1089/lap.2013.0172. Epub 2014 Jan 8.

Videoendoscopic single-port nipple-sparing mastectomy and immediate reconstruction

Mustafa Tukenmez  1 , Burcu Celet Ozden, Orhan Agcaoglu, Mustafa Kecer, Vahit Ozmen, Mahmut Muslumanoglu, Abdullah Igci
Affiliations

Videoendoscopic single-port nipple-sparing mastectomy and immediate reconstruction

Mustafa Tukenmez et al. J Laparoendosc Adv Surg Tech A. 2014 Feb.

Abstract

Purpose: Single-incision videoendoscopic surgery has recently become popular as a result of the ongoing search for less invasive procedures. The aim of this study was to evaluate the safety and efficacy of endoscopic single-port nipple-sparing mastectomy, axillary lymphadenectomy, and immediate reconstruction in patients with breast cancer.

Patients and methods: From May 14, 2012 through January 23, 2013, 10 patients underwent videoendoscopic single-port nipple-sparing mastectomy and axillary dissection via a single, limited incision and immediate prosthetic reconstruction. Patient charts were reviewed, and demographic data, operative time, complications and pathology results were analyzed.

Results: In all patients, videoendoscopic surgery was performed successfully. Of 10 patients, 7 were diagnosed as having invasive ductal carcinoma, 2 had a ductal carcinoma in situ, and 1 underwent bilateral prophylactic mastectomy. The weight of the resected gland was 300-650 g, with a mean of 420 g. There were no operative complications, and the mean operative time was 250 minutes (range, 160-330 minutes). One-stage reconstruction with implants was performed on 4 patients, whereas expanders were placed in the remaining 6. Surgical margins of all cases were pathologically negative, and there were no recurrences observed during the early follow-up period.

Conclusions: Videoendoscopic single-port nipple-sparing mastectomy is technically feasible even in larger breasts, enabling immediate reconstruction with good cosmetic outcomes. However, further studies with larger clinical series and long-term follow-up are required to compare the safety and efficacy of the technique with those of the standard nipple-sparing mastectomy.

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Figures

<b>FIG. 1.</b>
FIG. 1.
Photograph showing the bimanual dissection of the nipple to effectively core out the ductal extensions.
<b>FIG. 2.</b>
FIG. 2.
Operative photograph taken after the completion of gland resection.
<b>FIG. 3.</b>
FIG. 3.
(Upper panels) Photographs showing a patient with invasive ductal carcinoma of the right breast. (Lower panels) Three weeks after videoendoscopic nipple-sparing mastectomy of the right breast and immediate insertion of a 450-mL expander.
<b>FIG. 4.</b>
FIG. 4.
Invasive ductal carcinoma of the right breast: nipple sloughing at 1 week following videoendoscopic nipple-sparing mastectomy and immediate insertion of a 650-mL expander.
See this image and copyright information in PMC

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