内窥镜辅助腋窝入路双平面隆乳术应用研究

Transaxillary dual-plane augmentation mammoplasty with endoscope

目的：探讨在内窥镜辅助下腋窝入路双平面法隆乳术的应用。方法：全麻下，采用腋窝切口，在10mm30°内窥镜直视下用电钩沿胸大肌后间隙精确剥离受植腔隙，并在第五肋间水平处横行离断胸大肌，暴露乳腺和皮下组织，置入硅凝胶乳房假体后使假体大部分被胸大肌覆盖而近乳房下皱襞处被乳腺覆盖，形成双平面覆盖。结果：21例患者术后疼痛评分均在2分以下，明显小于普通盲视下腋窝入路胸大肌后隆乳术后患者的疼痛评分。无血肿发生；随访2～6个月，所有患者双侧乳房外形自然、对称，乳房下极饱满，形态长期自然稳定，手感良好，无疼痛及局部肿胀轻，无包膜挛缩发生。结论：在内窥镜辅助下，经腋窝入路双平面法隆乳术能精确剥离，预先止血，术后乳房下极饱满，并发症少，是一种值得推广的隆乳手术方法。

Objective To explore the application of transaxillary dual-plane augmentation mammoplasty with endoscope. Methods General anesthesia,the axillary incision,Subpectoral space was stripped by using electric hook in the endoscope（in 10 mm,30 degree）.At the fifth intercostal transverse transection of the pectoralis major,exposed mammary and subcutaneous tissue.Then put the silicone gel breast implants into the subpectoral space.The implants were covered by pectoralis major and mammary. Results All 21 patients had a postoperative pain score of less than 2 points,no hematoma.The follow-up period was 2 to 6 months,all patients with bilateral breast natural shape, symmetry,under very plump breasts,feel good,no pain,no capsule contracture, and with satisfactory results. Conclusion In endoscopic assisted by transaxillary dual-plane augmentation mammoplasty can accurately peeled pre bleeding,fewer complications,to meet the requirements of the modern woman on natural beauty.