Endoscopic Nipple-Sparing Mastectomy with Immediate Prepectoral Implant-Based Reconstruction: First Report of Surgical Technique

Gauthier Rathat, Christian Herlin, Christophe Bonnel, Guillaume Captier and Martha Duraes

Department of Oncological Breast Surgery, Montpellier Hospital, France
Department of Plastic Surgery, Montpellier Hospital, France
Innovative Extractor, Montpellier Hospital, University of Montpellier, France
Laboratory of Anatomy, University of Montpellier, Montpellier, France
Department of Gynaecological Surgery, Montpellier University Hospital, France

^*Correspondance to: Martha Duraes 

 PDF  Full Text DOI: 10.25107/2474-1647.2542

Abstract

Introduction: Technical innovations allow endoscopic Nipple-Sparing Mastectomy (NSM), which is well tolerated and associated with greater patient satisfaction. Endoscopic technique did not have wide diffusion; many centers have abandoned this technique because of technical challenges. Implant-Based Reconstruction (IBR) remains the most common form of breast reconstruction. Current techniques involve partial or total coverage of the implant with pectoralis major muscle to prevent exposure or infection. Muscle dissection has functional and cosmetic consequences. Methods: We present a case of 45 year-old patient presenting with personal history of right breast cancer. Patient requested left prophylactic mastectomy. We used a 4cm-long single hidden scar on axillary line. Endoscopic nipple-sparing mastectomy was done using a single port with three sleeves. Immediate breast reconstruction was performed by inserting a silicon implant in prepectoral plane without Acellular Dermal Matrix (ADM). Results: At 6 months postoperatively, no complication had been reported. The patient was satisfied with the result and no further correction was necessary. Conclusion: Endoscopic surgery is a valuable option for nipple-sparing mastectomy. This method is a less expensive alternative technique to robotic approach. It could enable safe prepectoral IBR without placement of ADM and with lower risk of complications.

Keywords

Breast implantation; Carcinoma; Endoscopy; Mammaplasty; Subcutaneous mastectomy

Cite the article

Rathat G, Herlin C, Bonnel C, Captier G, Duraes M. Endoscopic Nipple-Sparing Mastectomy with Immediate Prepectoral Implant-Based Reconstruction: First Report of Surgical Technique. Clin Surg. 2019; 4: 2542.