The increasing use of endoscopic surgical techniques can, in our opinion, be of use in breast reconstruction involving the insertion of permanent expanders. This paper includes 15 patients undergone Madden modified radical mastectomy, 9 of which underwent immediate reconstruction and 6 delayed reconstruction. The use of prostheses is currently the world most used technique in reconstruction after mastectomy. With a special surgical video equipment that comprehends a 10 or 5 mm optic, a retractor with or without optical access, a blunt dissector, an endoscopic cautery with or without sucker and irrigator and a suction device, it is possible to have a good view of the surgical field, when preparing the pouch, which is not always available with traditional techniques. This makes the detachment of the pectoralis major more accurate and facilitates bleeding control with subsequent shorter operating time and less post-operative complications. Despite the high cost of the equipment and the need to train the operator, surgical endoscopy has many advantages both in immediate and delayed breast reconstruction.
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