Air-Assisted Mastectomy Using LigaSure for a Breast Cancer Patient With a Cardiac Pacemaker

Mastectomy is often performed using unipolar electrocautery. However, for patients with a pacemaker, alternative methods are necessary, as the use of unipolar cautery is not recommended. In the case presented herein, we made half-centimeter incisions on the skin to be removed. We then pumped air under the mastectomy flaps through these incisions using a hand pump and a lipoplasty cannula equipped with a filter. Following this, we made a Stewart incision and conducted the dissection using a LigaSure vessel-sealing device from the plane formed by the air. The surgery was successfully completed without any significant bleeding, and the patient was discharged without any complications. Notably, this innovative surgical technique was employed for the first time in a breast cancer patient. The cannula we developed has facilitated the creation of a dissection plane using air, similar to endoscopic mastectomy, without requiring additional ports or equipment. This technique has the potential to facilitate surgery for selected patients.