7-step endoscopic nipple-sparing mastectomy with implant-based breast reconstruction: nipple sensation preservation and low complications.
Single-port endoscopic nipple-sparing mastectomy (E-NSM) with implant-based breast reconstruction (IBBR) represents a promising surgical technique. However, the surgical procedures are complex and lack standardized and systematic surgical protocols. The seven-step method was introduced as a means of simplifying the complex surgical procedures, with detailed descriptions provided of the key points and critical aspects of the surgery.
The medical records of patients who received single-port E-NSM with IBBR guided by the seven-step method from January 2022 to March 2024 were analyzed. The preliminary results were presented.
A total of 65 patients were enrolled in the study, who received 93 procedures of single-port E-NSM with IBBR following the seven-step method. The mean age was 41.7 ± 8.2 years, and the mean body mass index (BMI) was 22.81 ± 3.5 kg/m2. All patients had breasts of C cup size or smaller. One case required nipple-areola complex (NAC) removal due to tumor involvement, while no involvement of the surgical margins was detected. The mean operative time was 258.6 ± 71.2 min, and the mean intraoperative blood loss was 27.7 ± 20.5 ml. The overall complication rate was 8.6%, with six cases (6.5%) of nipple partial ischemia observed. No case experienced nipple necrosis. All reported complications were classified as minor. In Breast-Q "Satisfaction with Breasts" module, the mean score was 65.7 ± 18.0. The "physical well-being of chest" score was 73.9 ± 13.6. All four sensory types of the nipple-light touch, temperature, pressure, and pain-as well as erectile function, were preserved at favorable rates following the procedure. As of the last follow-up, no patients experienced local recurrence, distant metastasis, or mortality.
Single-port E-NSM with IBBR, guided by the seven-step method, is a safe and feasibility surgical approach. It is associated with a low complication rate, good cosmetic outcomes, and reasonable preservation of nipple sensation and erectile function. This technique appears particularly suitable for patients with breast sizes of C cup or smaller. The proposed seven-step method may provide a valuable framework for clinical practice and serve as a practical reference for peers, thereby contributing to the establishment of standardized and systematic surgical protocols.
The medical records of patients who received single-port E-NSM with IBBR guided by the seven-step method from January 2022 to March 2024 were analyzed. The preliminary results were presented.
A total of 65 patients were enrolled in the study, who received 93 procedures of single-port E-NSM with IBBR following the seven-step method. The mean age was 41.7 ± 8.2 years, and the mean body mass index (BMI) was 22.81 ± 3.5 kg/m2. All patients had breasts of C cup size or smaller. One case required nipple-areola complex (NAC) removal due to tumor involvement, while no involvement of the surgical margins was detected. The mean operative time was 258.6 ± 71.2 min, and the mean intraoperative blood loss was 27.7 ± 20.5 ml. The overall complication rate was 8.6%, with six cases (6.5%) of nipple partial ischemia observed. No case experienced nipple necrosis. All reported complications were classified as minor. In Breast-Q "Satisfaction with Breasts" module, the mean score was 65.7 ± 18.0. The "physical well-being of chest" score was 73.9 ± 13.6. All four sensory types of the nipple-light touch, temperature, pressure, and pain-as well as erectile function, were preserved at favorable rates following the procedure. As of the last follow-up, no patients experienced local recurrence, distant metastasis, or mortality.
Single-port E-NSM with IBBR, guided by the seven-step method, is a safe and feasibility surgical approach. It is associated with a low complication rate, good cosmetic outcomes, and reasonable preservation of nipple sensation and erectile function. This technique appears particularly suitable for patients with breast sizes of C cup or smaller. The proposed seven-step method may provide a valuable framework for clinical practice and serve as a practical reference for peers, thereby contributing to the establishment of standardized and systematic surgical protocols.
Authors
Huang Huang, Wu Wu, Fu Fu, Guo Guo, Lin Lin, Chen Chen, Li Li, Chen Chen, Li Li
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