Application of the Downward-Turned Patch-Wrapped Prosthesis Method in Transaxillary Single-Port Endoscopic Breast Reconstruction

This study presents an innovative breast reconstruction technique using an axillary single-port endoscopic approach with immediate breast reconstruction for breast cancer. The procedure begins with a concealed incision along the axillary fold that serves as a sentinel lymph node biopsy and endoscopic access. Under high-definition endoscopic visualization, meticulous dissection of the posterior space of the pectoralis major muscle and the retromammary space is performed, preserving critical neurovascular structures. A unique subcutaneous tunneling technique using long curved scissors enables the thorough separation of the breast parenchyma from the subcutaneous tissues, facilitating the en bloc resection of the mammary glands. The nipple-areolar complex was subjected to intraoperative frozen section analysis to confirm margin clearance. A critical step involves expertly folding and turning the patch upward before inserting it along the free edge of the pectoralis major muscle, where it is secured in place through continuous suturing. Surgical innovation is centered on patch manipulation protocols. The prosthesis is meticulously wrapped in a downwardly positioned patch to ensure complete enclosure and protection. The findings of this study strongly suggest that this single-port axillary endoscopic radical mastectomy, complemented by an innovative downward patch-wrapping technique, represents an effective and superior approach for the treatment of breast cancer, providing favorable outcomes and improved recovery experiences. This procedure was successfully performed in 30 patients at our hospital, with an average operating time of 147.73 min and a mean follow-up period of 17 months, and the BREAST-Q score post-operation was higher than that of pre-operation. These results indicate significant advantages over traditional reconstruction methods regarding aesthetic outcomes and postoperative recovery.