内窥镜辅助隆乳术

Endoscopic assisted augmentation mammoplasty\

目的 减少常规隆乳术盲视下操作分离假体置入腔隙而造成的创伤 ,提高隆乳术效果 ,探讨内窥镜在隆乳术中的应用。方法 自 1996年 5月起在内窥镜辅助下行胸大肌下置入腔隙的分离、止血及肌肉、筋膜的剥离、切割 ,17例置入假体 34个 ,其中经腋切口 7例 ,乳晕旁切口 9例 ,乳房下皱襞切口 1例。结果 应用内窥镜辅助进行隆乳术可以减少组织损伤 ,经乳晕旁切口可以更直接和准确地分离和切割胸大肌内下份起点、腹直肌前鞘和腹外斜肌筋膜 ,形成分离彻底的置入腔隙和良好的乳房下皱襞形态 ,防止乳房假体上移及位置不正。术后无出血、感染等并发症。 10例术后经随访 3～ 12月 ,均无包膜挛缩 ,外形及手感良好。结论 内窥镜辅助隆乳术对置入腔分离、止血彻底 ,可减少血肿、感染等并发症 ,降低包膜挛缩的发生率 ,有助于获得良好的手术效果。

Objective\ The breast augmentation is one of the established aesthetic operations. The major disadvantage of the operation is the invisibility during the blunt dissection of the implant pocket. to decrease the injury during the pocket dissection and to improve the operative result, the endoscope has been applied in augmentation mammoplasty. Methods\ Since May of 1996, we have placed 34 breast implants to subpectoral pockets in 17 patients aged 24 to 46 years utilizing endoscopic assisted technique. The breast prostheses were implanted through a transaxillary approach in 7 patients, periareolar incision in 9 patients and inframammary incision in one. The 10 mm 0 degree laparoscope and 4 mm 30 degree arthroscope with a video monitor make this procedure easy and safe. Results\ This technique allows accurate haemostases in the implant pocket and controlled dividing of the inferior medial origin of the pectoral muscle and the anterior sheath of the rectus abdominis, the fascia of the obliquus externus abdominis under direct visualization. The procedure is easier through the periareolar approach, resulting in sufficient subpectoral space dissection for proper prosthesis implantation and natural inframammary creases. There have been no postoperative complications, such as haematoma and infection. Follow up of ten patients for 3 to 12 months showed that there have been no capsular contracture and the breasts are soft with good appearance. Conclusion\ We believe that endoscopic assisted mammoplasty offers more satisfactory clinical results with less haematoma and infection, less possibility of capsular contracture.\;