Does Teamwork Make the Dream Work? A Dual-Surgeon Technique for Endoscopic Bilateral Nipple-Sparing Mastectomy With Immediate Breast Reconstruction.

Abstract

Endoscopic nipple-sparing mastectomy (E-NSM) with immediate breast reconstruction (IBR) represents a key surgical technique in the evolution of minimally invasive breast surgery. For endoscopic bilateral nipple-sparing mastectomy (E-BNSM) with IBR, all surgical steps are typically performed by a single surgeon. Given the complexity of E-BNSM with IBR, we proposed the dual-surgeon (DS) technique as an alternative approach. In this study, the authors compared the surgical outcomes between the single-surgeon and dual-surgeon approaches. A retrospective review was conducted on all patients who underwent E-BNSM with IBR at a single institution between March 2021 and March 2024. Patients were divided into two cohorts based on the number of surgeons involved during the procedure: a single-surgeon (SS) cohort and a DS cohort. Baseline characteristics and surgical outcomes were analyzed and compared between the two cohorts. A total of 47 patients were included in this study, with 26 undergoing the SS approach and 21 undergoing the DS approach. Baseline characteristics were similar between the two groups. Compared to the SS approach, the DS approach decreased the mean operative time by 36.8 min (p = 0.036). Intraoperative blood loss, postoperative hospital stays, and operation costs were comparable between the two cohorts (p > 0.05). No statistically significant differences were observed in postoperative complications, final pathology results, and oncological outcomes. The DS technique positively influenced outcomes in E-BNSM with IBR, significantly reducing operative time. This innovative technique holds potential clinical utility, warranting further validation through larger-scale studies.