Soft Tissue Endoscopy-A New Spectrum of Endoscopic Surgery

Purpose: Historically, open surgery has been the treatment of choice for soft tissue lesions. This study aims to report an innovative soft tissue endoscopic surgery for subcutaneous and intramuscular lesions at our center. Methods: For this retrospective review, data on sex, age, symptoms, diagnosis, sites of surgery, previous treatment, surgery, and follow-up were collected from our Vascular Anomalies Center database. Patients with soft tissue lesions who had undergone endoscopic surgery between September 2019 and March 2024 were included. Soft tissue endoscopic surgeries included totally endoscopic surgery, endoscopy-assisted surgery, and conversion to open surgery. Results: In total, 122 patients were included: 74 females and 48 males, with ages ranging from 1 to 38 years (median, 7.5 years). Conditions for endoscopic surgery included various vascular anomalies and benign soft tissue tumors. Surgical sites included the lower extremity, upper extremity, abdominal wall, thoracic wall, back, gluteal region, and face. One hundred patients underwent totally endoscopic surgery, and 22 underwent endoscopy-assisted or conversion to open surgery. The operative duration was 40-530 minutes (median, 222 minutes). Blood loss was 1-1400 mL (median, 30 mL). No hemorrhage or wound dehiscence was observed within 30 days after surgery. Conclusions: Various subcutaneous and intramuscular conditions can be successfully managed with soft tissue endoscopic surgery. We think that this novel treatment approach can provide valuable references for clinicians of many specialties, encompassing general surgery, pediatric surgery, vascular surgery, plastic surgery, dermatologic surgery, and orthopedics.