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Traumatic Brain Injury l: Introduction01:28

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Single-Port Endoscopic Nipple-Sparing Mastectomy Using a Handheld Motorized Articulating System: Technical

Vasileios Kalles1, Apostolos Mitrousias2, Apostolos Vlachogiorgos2

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A new articulating surgical system makes endoscopic nipple-sparing mastectomy (NSM) technically feasible, improving dissection in difficult breast cancer surgery areas. This minimally invasive technique shows promise for breast reconstruction outcomes.

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Area of Science:

  • Surgical Oncology
  • Minimally Invasive Surgery
  • Breast Surgery

Background:

  • Endoscopic nipple-sparing mastectomy (NSM) offers cosmetic benefits but is challenging with standard instruments.
  • The HandX™ articulating system provides enhanced dexterity for endoscopic breast procedures.
  • Previous applications of this articulating system in endoscopic breast surgery were not reported.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of using the HandX™ articulating system for single-port endoscopic NSM.
  • To assess the system's utility in challenging dissection areas of the breast.
  • To determine the safety and efficacy of this technique in immediate implant-based reconstruction.

Main Methods:

  • The first clinical use of the HandX™ articulating system in single-port endoscopic NSM was performed.
  • Two patients underwent NSM via a lateral incision, one therapeutic and one prophylactic.
  • Articulating scissors were used for dissection, followed by prepectoral implant reconstruction.

Main Results:

  • All procedures were completed successfully without intraoperative complications.
  • Operative times were 240 minutes (unilateral) and 250 minutes (bilateral).
  • Patients were discharged within 48 hours with no early or late complications, and achieved good pathological outcomes.

Conclusions:

  • Single-port endoscopic NSM with a motorized articulating system is technically feasible.
  • The system facilitates dissection in challenging medial, inferior, and retroareolar regions.
  • This technique offers a minimally invasive option between robotic and conventional endoscopy, warranting further study.