Usefulness of cordless ultrasonic cutting energy devices in endoscopic nipple-sparing mastectomy: a retrospective study
	    		
		   		
		   			
		   		
	    	
    	 
    	10.4174/astr.2024.106.3.147
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Byeongju KANG
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Heejung KEUM
			        		
			        		;
		        		
		        		
		        		
			        		Ho Yong PARK
			        		
			        		;
		        		
		        		
		        		
			        		Jin Hyang JUNG
			        		
			        		;
		        		
		        		
		        		
			        		Wan Wook KIM
			        		
			        		;
		        		
		        		
		        		
			        		Jeeyeon LEE
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:ORIGINAL ARTICLE
 
        	
        	
            
            
            	- From:Annals of Surgical Treatment and Research
	            		
	            		 2024;106(3):147-154
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
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		        	Abstract:
			       	
			       		
				        
				        	 Purpose:Endoscopic nipple-sparing mastectomy (E-NSM) is a minimally invasive surgical technique that shows good results in patients with breast cancer. The authors compared 3 different types of commercial energy devices to examine their efficacy and safety in E-NSM performed with breast reconstruction. 
				        	
				        
				        	Methods:A total of 36 cases of E-NSM were conducted with either Sonicision (S group, n = 11), Harmonic (H group, n = 6), or Thunderbeat (T group, n = 19). The clinicopathologic factors and postoperative complications, including nipple or skin necrosis and surgical site seroma volume, were evaluated for 3 months after surgery. 
				        	
				        
				        	Results:The surgical duration of E-NSM was significantly shorter in the S group than in the H group (P = 0.043) and T group (P = 0.037). However, the total surgical duration including E-NSM and breast reconstruction, and the total and daily drainage volume of postoperative seroma did not differ significantly among the 3 groups. Even when the energy devices were compared according to their working principle, i.e., ultrasonic (S and H) vs. hybrid (T), the total breast surgery duration and total and daily drainage volume of seroma showed no difference between the 2 groups. Although surgeon satisfaction did not significantly differ when using 3 devices for E-NSM (P = 0.428), surgeon’s fatigue was found to be lowest in the S group, though it was not significant (P = 0.064). 
				        	
				        
				        	Conclusion:Any energy device can be safely used for E-NSM with breast reconstruction without causing any major complications. However, cordless ultrasonic energy devices allow greater mobility for the surgeon and, therefore, may shorten surgical time in breast surgery.