A novel surgical technique of use of the Goligher self-retaining retractor for microvascular anastomosis in reconstruction after minimally invasive mastectomy.
| Title: | A novel surgical technique of use of the Goligher self-retaining retractor for microvascular anastomosis in reconstruction after minimally invasive mastectomy. |
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| Authors: | Sim DPY; Department of Breast Surgery, Sengkang General Hospital, Singapore, Singapore.; Sim NHS; Department of Plastic, Reconstructive and Aesthetic Surgery, Sengkang General Hospital, Singapore, Singapore.; Ngaserin S; Department of Breast Surgery, Sengkang General Hospital, Singapore, Singapore.; Leong FQ; Department of Breast Surgery, Sengkang General Hospital, Singapore, Singapore.; Chua HW; Department of Breast Surgery, Sengkang General Hospital, Singapore, Singapore.; Tan BK; Department of Breast Surgery, Sengkang General Hospital, Singapore, Singapore.; Wong AW; Department of Plastic, Reconstructive and Aesthetic Surgery, Sengkang General Hospital, Singapore, Singapore. |
| Source: | Gland surgery [Gland Surg] 2024 Dec 31; Vol. 13 (12), pp. 2409-2413. Date of Electronic Publication: 2024 Dec 27. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: AME Publishing Company Country of Publication: China (Republic : 1949- ) NLM ID: 101606638 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2227-684X (Print) Linking ISSN: 2227684X NLM ISO Abbreviation: Gland Surg Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Hong Kong : AME Publishing Company |
| Abstract: | In recent years, minimally invasive breast surgery (MIBS) has revolutionized breast cancer treatment, allowing for preservation of aesthetic outcomes while ensuring oncological safety. However, this has created a new challenge in maintaining optimal visualization and dexterity during microvascular anastomosis which is critical for successful autologous tissue reconstruction. Traditional retractors often limit maneuverability, potentially impacting the outcomes of anastomotic procedures. We describe a novel use of the Goligher self-retaining retractor in microvascular anastomosis through an inframammary fold (IMF) incision in 6 breast cancer patients who underwent endoscopic total mastectomy (ETM) with free abdominal-based flap reconstruction. After the ETM is performed via an IMF incision, the Goligher retractor is assembled to retract the tissues for optimal visualisation and exposure for microvascular anastomosis. The average ischaemic time was 37.3 minutes (range, 22-50 minutes). One case required re-exploration, no flap failure occurred and no nipple/skin ischaemia/necrosis occurred. Our surgeons reported enhanced visibility, leading to more precise suturing and reduced operative times. This may correlate with a lower incidence of complications and favorable aesthetic outcomes. Overall, the Goligher retractor presents an excellent adjunct in the field of minimally invasive mastectomy reconstruction and its integration into surgical practice may contribute to improved surgical outcomes.; (2024 AME Publishing Company. All rights reserved.) |
| Competing Interests: | Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-24-262/coif). The authors have no conflicts of interest to declare. |
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| Contributed Indexing: | Keywords: Micro-anastomosis; minimally invasive mastectomy reconstruction; retraction method |
| Entry Date(s): | Date Created: 20250117 Latest Revision: 20250129 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11733637 |
| DOI: | 10.21037/gs-24-262 |
| PMID: | 39822364 |
| Database: | MEDLINE |
Journal Article