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Endoscopic axillary exploration and sentinel lymphadenectomy
T N Tsangaris1, K Trad, F J Brody
1Department of Surgery, the Washington Institute of Surgical Endoscopy, and the Breast Care Center, The George Washington University, 2150 Pennsylvania Avenue, N.W., Washington, DC 20037, USA.
Surgical Endoscopy
|December 31, 1998
Summary
A new endoscopic technique allows minimally invasive evaluation of the axilla in breast cancer patients. This approach enables clear visualization and identification of lymph nodes and key anatomical structures.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Breast Cancer Management
Background:
- Minimally invasive surgical techniques are increasingly adopted across various surgical specialties.
- Traditional axillary evaluation in breast cancer patients can be invasive.
Purpose of the Study:
- To develop and describe a reproducible endoscopic technique for axillary evaluation in breast cancer patients.
- To establish a minimally invasive method for assessing axillary lymph nodes.
Main Methods:
- A novel endoscopic technique was developed involving a small skin incision, balloon distention for workspace creation, and laparoscopic visualization.
- The procedure was performed on 23 patients with biopsy-proven breast carcinoma.
- Sentinel lymph node identification was attempted in 19 patients.
Main Results:
- The technique successfully created a minimally invasive workspace, allowing clear visualization of the axillary vein and critical nerves.
- Lymph nodes were easily identified and extracted.
- Sentinel lymph nodes were identified in 11 of 19 patients, with no reported complications and 84% procedure concordance.
Conclusions:
- A novel endoscopic technique for minimally invasive axillary evaluation in breast cancer patients has been successfully developed.
- This technique facilitates workspace creation, identification of anatomical landmarks, and lymph node retrieval.
- It represents the first minimally invasive approach for axillary exploration incorporating sentinel lymph node mapping.