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Single-Port Three-Dimensional Endoscopic-Assisted Axillary Lymph Node Dissection (S-P 3D E-ALND): Surgical Technique
Chayanee Sae-Lim1, Hung-Wen Lai2,3,4,5,6,7,8,9, Papawee Chennavasin10
1Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
The Breast Journal
|January 1, 2025
Summary
Single-port 3D endoscopic-assisted axillary lymph node dissection (E-ALND) offers improved visualization for breast cancer patients. This minimally invasive technique shows promising results with no major complications and good oncological outcomes.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Breast Cancer Treatment
Background:
- Endoscopic-assisted breast surgery (EABS) enhances cosmetic outcomes via small incisions.
- Conventional axillary lymph node dissection (ALND) often requires extended incisions and significant retraction.
- A novel single-port 3D endoscopic-assisted ALND (S-P 3D E-ALND) is proposed to overcome these limitations.
Purpose of the Study:
- To introduce and evaluate the preliminary outcomes of a single-port 3D endoscopic-assisted axillary lymph node dissection (S-P 3D E-ALND).
- To assess the feasibility, safety, and short-term oncological efficacy of this innovative surgical approach.
Main Methods:
- S-P 3D E-ALND was performed using monopolar Endo Hook, LigaSure, or Sonicision.
- Eleven breast cancer patients underwent the procedure between January and September 2023.
- Retrospective analysis of perioperative parameters, complications, and oncological outcomes was conducted.
Main Results:
- The S-P 3D E-ALND achieved a 100% success rate without conversion to open surgery.
- Median operative time was 39 minutes with minimal blood loss (median 3 mL).
- Median of 10 lymph nodes were harvested; no complications, lymphedema, or numbness were observed during 7-month follow-up. No recurrence or metastasis reported.
Conclusions:
- S-P 3D E-ALND is a viable alternative for axillary lymph node dissection in breast cancer patients undergoing EABS.
- The technique offers excellent visualization and leads to only minor complications.
- Further research is warranted to confirm long-term oncological safety and benefits.
