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Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
Published on: September 15, 2023
Endoscopic transaxillary capsulectomy
1Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University, Medical School, China. yuoli@sh163a.sta.net.cn
Background:
Traditionally, breast implant extraction and capsulectomy have been performed using a transareolar approach. However, this approach is not acceptable to Chinese patients because of the additional scar formation. The authors present their experience with capsulectomy using transaxillary endoscopic assistance without the need for an additional incision.
Methods:
The former transaxillary incisional scar for augmentation mammoplasty is used. Blunt dissection is performed to the outer surface of the fibrous capsule. A 30 degrees , 10-mm endoscope is placed through the axillary incision to dissect the outer surface of the capsule. After this is finished, the capsule is cauterized open, and extraction is completed. Transaxillary capsulectomy is performed under endoscopic control.
Results:
From 2003 to 2005, a total of 30 breasts involving 15 patients were treated. The follow-up period was 4 to 6 months, with favorable results. No scar was left on the breast, and no additional scar was made. No liquid accumulation was identified.
Conclusions:
Endoscopic transaxillary capsulectomy can be completed through the axillary incision. The technique successfully removed the fibrous capsule, eliminated the needed for an incision on the breast, and created an incision far from the breast for completion of the procedure.

