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      Videoendoscopic single-port axillary dissection

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          Abstract

          Videoendoscopy is newly used in breast and axillary surgery. Single-port surgery is one of the newest methods of minimally invasive surgery. This report describes the first case of videoendoscopic single-port axillary dissection. In histopathological evaluation, 24 lymph nodes were identified and one node was infiltrated by the cancer cells. Videoendoscopic single-port axillary dissection is a precise and improvable technique. Single-port videoendoscopic axillary dissection could be more feasible with individual tools that will be designed for minimally invasive breast surgery.

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          Single access retroperitoneoscopic adrenalectomy (SARA)--one step beyond in endocrine surgery.

          Piero F Alesina, Martin K. Walz (2009)
          Today, endoscopic adrenalectomy has become a gold standard in endocrine surgery. To minimize the morbidity and improve cosmesis, a single access retroperitoneoscopic adrenalectomy (SARA) has been developed. Patients were placed in prone position. Through a single 1.5 cm skin incision at the tip of the 12th rib the creation of the retroperitoneal space and the dissection of the adrenal gland were performed. SARA was used in five patients with adrenal tumors (size: 1-4 cm; four right, one left). Operating time ranged from 35 to 70 min, mean blood loss was <10 ml. No perioperative or postoperative complications were noticed. Mean hospital stay was 2 days. SARA is feasible and represents a new horizon in endocrine surgery.
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            Long-term outcomes of breast cancer patients after endoscopic axillary lymph node dissection: a prospective analysis of 52 patients.

            Alvaro I Langer, M Zuber, J Torhorst … (2005)
            Reports on long-term outcomes after endoscopic axillary lymph node dissection (ALND) of breast cancer patients are still lacking in the medical literature. The objective of this prospective study was to assess the oncological and functional outcomes in breast cancer patients after endoscopic ALND. Fifty-five breast cancer patients were prospectively enrolled, of whom 52 were available for follow-up with a median of 71.9 months (range 11-96). The following oncological and functional endpoints were evaluated during follow-up at several time points: occurrence of local, axillary and distant metastases, seroma or infection, shoulder mobility (range of motion), numbness, pain, presence of lymphoedema as well as restriction in activities of daily living. In 52 patients endoscopic ALND of level I and II was successfully performed. Two port-site metastases (2/52, 4%) occurred, one of which in a patient with negative axillary lymph nodes. The same patient suffered from the only axillary recurrence (1/52, 2%). Three patients (3/52, 6%) developed lymphoedema. No other functional adverse events (shoulder mobility, pain, numbness, hypertrophic scar) were noticed at the end of the observation period. The present investigation with long-term follow-up after endoscopic ALND--the first one in the literature--reveals minor morbidity, good functional and cosmetic results. In contrary to conventional surgery, the endoscopic procedure is associated with the occurrence of port-site metastases, not seen in the open approach. Axillary recurrences do not appear more frequently when compared with results after conventional ALND. In the meantime the less invasive sentinel lymph node (SLN) biopsy is the established standard technique in evaluating the axillary lymph node status.
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              Endoscopic axillary lymphadenectomy without prior liposuction in 100 patients with invasive breast cancer.

              S Malur, J Bechler, Marc Schneider (2001)
              The purpose of this study was to evaluate intra- and postoperative outcome after endoscopic axillary lymphadenectomy without liposuction. One hundred patients with early stage breast cancer were treated by breast conserving therapy and endoscopic technique. The median duration of operation was 75 minutes (30-130 minutes). Switching from endoscopy to an open technique was necessary for two patients. The median number of removed lymph nodes was 16. Postoperatively, seroma developed in four patients, temporal winged scapula developed in three patients, and a wound infection in one patient. On postoperative day 5, arm mobility was not restricted for 89 patients. After a median follow-up of 14 months, 14 patients reported persistent impairment of sensibility, and two patients did not have full shoulder mobility. Axillary recurrence has not developed in any patient. Endoscopic axillary lymphadenectomy can be performed safely without previous liposuction.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Minim Access Surg
                Journal ID (publisher-id): JMAS
                Title: Journal of Minimal Access Surgery
                Publisher: Medknow Publications (India )
                ISSN (Print): 0972-9941
                ISSN (Electronic): 1998-3921
                Publication date (Print): Oct-Dec 2011
                Volume: 7
                Issue: 4
                Pages: 246-248
                Affiliations
                [1]Department of Surgery, Division of Breast Diseases, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
                Author notes
                Address for correspondence: Dr. Erman Aytac, Cerrahpasa Tip Fakultesi, Genel Cerrahi Anabilim Dali, Kursu Sekreterligi Kat:6, Fatih, Istanbul 34098, Turkey. E-mail: eaytactr@ 123456yahoo.com
                Article
                Publisher ID: JMAS-7-246
                DOI: 10.4103/0972-9941.85650
                PMC ID: 3193697
                PubMed ID: 22022116
                SO-VID: 5598c9b8-0857-421a-ad58-e346f1a74cc4
                Copyright © Copyright: © Journal of Minimal Access Surgery
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 13 November 2010
                Date accepted : 23 March 2011
                Categories
                Subject: How I Do It

                ScienceOpen disciplines: Surgery
                Keywords: single port,videoendoscopy,axillary dissection
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: single port, videoendoscopy, axillary dissection

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