Advantages of nipple margin resection using articulating instrument in endoscopic nipple-sparing mastectomy for breast cancer patients

초록

Introduction: Endoscopic Nipple-Sparing Mastectomy (E-NSM) using a single port is a minimally invasive surgical technique. However, the lack of articulation in endoscopic instruments can result in significant movement limitations. To address these constraints, this study was initiated to evaluate the use of articulated instruments, "Artisential®", designed to overcome these challenges. Methods: This retrospective study analyzed 53 patients diagnosed with breast cancer who underwent E-NSM at Korea University Ansan Hospital between April 2024 and September 2025. Among these, 30 patients (32 cases) underwent E-NSM using ArtiSential®. Clinical outcomes between the two groups were statistically compared. Results: Mean weight of the resected breast was similar in both groups, with the ArtiSential® group at 346.5 ± 142.70 grams and the non-user group at 349.35 ± 133.08 grams (p = 0.959). Surgical time during mastectomy also showed no significant difference between the two groups, with the ArtiSential® group taking 133.10 ± 54.99 minutes and the non-user group 146.78 ± 32.27 minutes (p = 0.376). Mean postoperative hospital stay was similar in both groups, with the ArtiSential® group at 13.60 ± 3.10 days and the non-user group at 13.09 ± 3.53 days (p = 0.680). Additionally, mean duration of the drain placement showed no significant difference, with the ArtiSential® group at 12.70 ± 3.23 days and the non-user group at 13.91 ± 4.45 days (p = 0.389). Lastly, the complication rates between the two groups were also similar, with 3 out of 30 patients (10%) in the ArtiSential® group and 3 out of 23 patients (13.0%) in the non-user group (p = 0.806). Conclusion: Endoscopic mastectomy utilizing articulated ArtiSential® instruments provides significant advantages in securing nipple margins and managing anatomically challenging angled regions. A comparative analysis of postoperative clinical outcomes revealed statistically comparable results between procedures performed with and without the use of ArtiSential® instruments, supporting their clinical efficacy. No conflict of interest