腋窝入路单孔腔镜电剪刀法乳房皮下腺体切除技术要点

Technical key points of endoscopic electro-scissors-assisted subcutaneous glandular excision of the breast via a single-port axillary approach

摘要:

传统开放乳房全切术创伤大且瘢痕明显，影响患者身心健康及生活质量。随着微创技术的发展，单孔腔镜辅助腋窝入路乳房皮下腺体切除术因切口隐蔽、美观性佳而逐渐受到关注。在此基础上，笔者团队开展了腔镜电剪刀辅助腋窝入路乳房皮下腺体切除术，并在临床实践中不断优化操作流程。该技术以腔镜电剪刀为主要分离工具，结合膨胀液辅助及标准化解剖层次，能够减少皮瓣热损伤，改善术野暴露并提高手术操作的精细度与安全性，同时具有学习曲线相对较短、易于掌握等特点。本文基于200余例手术经验，对术前准备、器械配置、手术步骤及关键操作要点进行系统总结，以期为乳腺外科微创手术的规范化开展提供参考。

Abstract:

Conventional open mastectomy is associated with significant surgical trauma and visible scarring, which may adversely affect patients' physical and psychological well-being as well as quality of life. With the advancement of minimally invasive techniques, single-port endoscopic subcutaneous mastectomy via the axillary approach has gained increasing attention due to its concealed incision and favorable cosmetic outcomes. Based on this approach, our team has developed an endoscopic electro-scissors-assisted technique and continuously refined the surgical procedure in clinical practice. Using electro-scissors as the primary dissection instrument, combined with tumescent infiltration and standardized anatomical planes, this technique helps reduce thermal injury to skin flaps, improve surgical exposure, and enhance procedural precision and safety. In addition, it features a relatively short learning curve and is easy to master. Based on experience from over 200 cases, this article systematically summarizes the preoperative preparation, instrumentation, surgical steps, and key technical points, aiming to provide a practical reference for the standardized implementation of minimally invasive breast surgery.