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Updated: May 21, 2025
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Video-assisted submuscular breast reconstruction: evaluating a novel technique in high-risk patients
Leonardo Barellini1, Simone Miccoli1, Benedetta Daicampi1
1Breast Surgery Unit, Livorno Hospital, Livorno, Italy.
Background:
Breast cancer is one of the most prevalent oncological diseases worldwide, with mastectomy often necessary for treatment. Post-mastectomy breast reconstruction is essential for restoring physical integrity and improving patients' quality of life, especially in high-risk individuals with advanced age, obesity, diabetes, smoking habits, or a history of radiotherapy. Traditional submuscular reconstruction techniques are effective but often associated with higher rates of complications in this patient population. This study aimed to evaluate the efficacy and safety of a novel video-assisted procedure (VAP) for submuscular breast reconstruction, focusing on its ability to reduce complications and enhance outcomes.
Methods:
A retrospective analysis compared 17 high-risk patients who underwent VAP with 127 patients treated using traditional non-video-assisted procedures (NVAP) between September 2022 and June 2024. Both groups were comparable in age, body mass index (BMI), and risk factors. Data on postoperative complications, including bleeding, wound dehiscence, and infections, were collected and analyzed. Statistical significance was determined using appropriate tests, with a P value <0.05 considered significant.
Results:
The VAP group demonstrated significant reductions in complications compared to the NVAP group. No cases of postoperative bleeding were reported in the VAP group, while 8.66% of NVAP patients experienced bleeding. Wound dehiscence rates were also lower in the VAP group (5.88%) compared to the NVAP group (10.24%). The minimally invasive nature of VAP allowed for precise dissection and reduced tissue trauma without prolonging surgical times.
Conclusions:
The findings suggest that VAP is a safer and more effective alternative for high-risk patients requiring submuscular breast reconstruction. By minimizing complications and enhancing both functional and aesthetic outcomes, VAP offers a promising innovation in reconstructive surgery. Larger, randomized trials are necessary to validate these results and establish VAP as a standard of care in diverse clinical settings.
