经腋窝入路内镜辅助双平面法解剖型假体隆乳术  

Transaxillary dual-plane breast augmentation with endoscope assistant

作　　者：栾杰 穆大力 穆蔚 刘晨 张卓奇 

机构地区：[1]中国医学科学院整形外科医院乳房整形与再造中心,北京100144

出　　处：《中华整形外科杂志》2009年第3期175-177,共3页Chinese Journal of Plastic Surgery

摘　　要：目的探讨应用内镜辅助技术，经腋窝入路双平面法硅凝胶假体隆乳术的可行性，并对手术操作经验进行总结。方法手术在全麻下进行。切口位于双侧腋窝皮肤自然皱褶处，长约4cm。以常规方法剥离胸大肌后间隙，在10mm-30°内镜辅助下，剪离断部分胸大肌。通过腋窝切口植入毛面解剖型硅凝胶乳房假体，常规留置负压引流3—5d。结果临床应用79例，术后随访时间6～12个月，与单纯胸大肌后假体隆乳患者相比，本组患者术后疼痛程度明显较轻，外形更为自然，手术效果满意，无包膜挛缩、血肿、瘢痕增生及感染等并发症出现。结论在内镜辅助下，可以经腋窝入路完成双平面法硅凝胶假体植入隆乳术。该方法将乳腺后间隙假体隆乳术及胸大肌后间隙假体隆乳术的优点相结合，切口隐蔽。在双平面法隆乳术中，当患者要求采用隐蔽切口时，应用该技术是非常合适的选择。Objective To investigate the feasibility of transaxillary dual-plane breast augmentation with endoscope assistant. Methods The submuscular pockets were separated through a 4 cm transverse incision in the axilla. The pectoralis major muscle were split from the costal margin with the help of a 10 mm, 30 degree endoscope and endoscopic diathermy scissors. Soft cohesive gel microtextured anatomic style silicone implants ranging in size from 185 to 315 g were placed through the axillary incision. The vacuum drainage was used for 3 -5 days. Results 79 patients underwent the dual-plane breast augmentation. Postoperative analgesia requirements were reduced because of muscle strength releasing. The follow-up period was 4 to 6 months with satisfactory results. All the patients had aesthetically natural appearance, with the nipple at the most projected part of the breast. No rippling, lateral displacement, double-bubble deformity, or muscle contraction-associated deformities were seen. There was no complications such as capsular contracture, hematoma, hypertrophic scar, and infection. Conclusions Dual-plane breast augmentation using textured silicon gel implant can be completed with the endoscope assistance through the axillary incision. The technique combined retromammary and partial retropectoral pocket locations to optimize the benefits of each pocket location while avoiding the drawbacks of extra incision on the breast.

关 键 词：内窥镜 隆乳术 双平面技术 

分 类 号：R655.8[医药卫生—外科学] R653[医药卫生—临床医学]