Surgeons at MedStar Georgetown University Hospital in Washington have begun performing nipple-sparing mastectomies with a single-port robot through one small incision hidden beneath the breast, an option MedStar says no other hospital in the Washington region offers.
In the first case MedStar described, a 50-year-old woman with early-stage breast cancer had both breasts’ tissue removed, a sentinel lymph node biopsy to check for spread and breast implants placed, all through one 4-centimeter incision in the natural fold under the breast, according to a MedStar Health release. Surgeons also used a nerve-sparing technique meant to help preserve sensation.
“One incision. One surgery,” said Dr. Lucy De La Cruz, chief of breast surgery at MedStar Georgetown and system chief of breast surgery for MedStar Health, who performed the procedure with plastic surgeon Dr. Kenneth Fan. She said the patient woke with her cancer treated and a scar she’ll barely see, and was home with family within hours.
How it’s different
Most hospitals that offer robotic nipple-sparing mastectomies make the incision in the armpit or along the side of the chest, MedStar said. The da Vinci SP system works through a single port, which lets surgeons reach the breast from under the fold.
MedStar says Georgetown is one of only 10 U.S. hospitals performing nipple-sparing mastectomies with the single-port system. The hospital says the smaller incision may mean less pain, faster recovery and less visible scarring. Those benefits come from the hospital; the release describes one patient’s experience, not a study of outcomes.
Who it’s for
The approach works best for patients with small to moderate-sized breasts, a healthy body weight and nipples in the right position, MedStar said. It isn’t recommended for patients with larger or sagging breasts or with inflammatory breast cancer.
MedStar also runs MedStar St. Mary’s Hospital in Leonardtown and MedStar Southern Maryland Hospital Center in Clinton. The release did not say whether the procedure will be offered at those hospitals.
