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Endoscopic axillary lymph node dissection: an experimental study in human cadavers

L M Brunt1, D B Jones, J S Wu

  • 1Department of Surgery and Institute for Minimally Invasive Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.

Journal of the American College of Surgeons
|August 15, 1998
PubMed
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Endoscopic axillary dissection is a feasible minimally invasive technique for breast cancer staging. This cadaver study demonstrated its safety and effectiveness in removing lymph nodes, paving the way for patient trials.

Area of Science:

  • Surgical Oncology
  • Minimally Invasive Surgery
  • Breast Cancer Management

Background:

  • Axillary lymph node dissection is crucial for breast carcinoma staging.
  • Minimally invasive techniques offer potential alternatives to open surgery.
  • Endoscopic approaches are being explored for axillary lymph node dissection.

Purpose of the Study:

  • To evaluate the technical feasibility of endoscopic axillary lymph node dissection.
  • To assess the safety of an endoscopic approach in human cadavers.
  • To compare endoscopic dissection with traditional open methods.

Main Methods:

  • Twelve axillary dissections were performed on seven human cadavers.
  • A small incision was used to access the axillary space, expanded with a balloon dissector.

Related Experiment Videos

  • Endoscopic dissection utilized three to four 5-mm ports for visualization and instrument insertion.

    • Main Results:

    • The average dissection time was 56.7 minutes.
    • Key neurovascular structures, including the axillary vein and thoracic nerves, were successfully visualized.
    • An average of 9.9 lymph nodes were removed per axilla, with no reported neurovascular injuries.

    Conclusions:

    • Endoscopic axillary dissection is technically feasible with current technology.
    • The procedure demonstrated safety in cadaveric dissection.
    • Further clinical trials in breast carcinoma patients are recommended to validate this technique.