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

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.