Background/Objectives: The aim of this case series is to evaluate the outcomes and safety of video-assisted mastectomy, illustrating the harmonious collaboration of oncologic and plastic surgery. This novel minimally invasive technique allows immediate prosthetic reconstruction and represents a cost-effective alternative to robotic breast surgery. Methods: Video-assisted, single-port nipple-sparing mastectomies were performed in patients with small to medium-sized breasts, followed by immediate direct-to-implant reconstruction with either prepectoral or dual plane implant placement. The patients’ electronic medical records were analyzed, including demographic characteristics, operative times and histopathology reports. Results: A total of 18 patients underwent successful video-assisted mastectomy, without conversion to traditional open procedure. Fifteen of the operations were risk-reducing mastectomies. Twelve patients had complementary procedures performed concurrently on the previously operated contralateral breast (delayed reconstruction/expander-to-implant exchange). Moreover, three patients benefited from additional minimally invasive techniques during the same surgery (prophylactic laparoscopic hysterectomy). Immediate breast reconstruction with polyurethane or microtextured breast implants up to 450 cc was performed, with satisfactory aesthetic outcomes and no cancer recurrences at 6 to 12 months postoperative follow-up. Early complications included transient hypercapnia, areolar congestion and cellulitis. No skin necrosis or implant-related complications were reported. The most frequently encountered late issues were contour irregularities. Conclusions: Video-assisted mastectomy facilitates the safe removal of proven pathologic or healthy breast tissue with minimal damage to the breast’s skin envelope, facilitating single-stage breast reconstruction.
背景/目的：本病例系列研究旨在评估视频辅助乳房切除术的疗效与安全性，以展示肿瘤外科与整形外科的协同合作。该新型微创技术可实现即刻假体重建，是机器人乳房手术的一种经济有效的替代方案。方法：对中小体积乳房患者实施单孔视频辅助保留乳头乳房切除术，随后采用胸肌前或双平面植入法进行即刻直接假体重建。通过分析患者电子病历，收集人口学特征、手术时间及组织病理学报告等数据。结果：18例患者均成功完成视频辅助乳房切除术，无中转传统开放手术病例。其中15例为风险降低性乳房切除术。12例患者在同期对侧乳房接受了联合手术（延期重建/扩张器-假体置换术）。此外，3例患者在同次手术中受益于其他微创技术（预防性腹腔镜子宫切除术）。所有患者均使用最大450毫升的聚氨酯或微纹理乳房假体完成即刻乳房重建，术后6-12个月随访显示美学效果满意且无肿瘤复发。早期并发症包括短暂性高碳酸血症、乳晕充血及蜂窝织炎。未出现皮肤坏死或假体相关并发症。最常见的远期问题是轮廓不规则。结论：视频辅助乳房切除术能在最大限度保护乳房皮肤完整性的前提下，安全切除确诊病变或健康的乳腺组织，为单阶段乳房重建提供了有效解决方案。
肿瘤(癌症)患者之家