October 1997

Invited Commentary

Author Affiliations

New York, NY

Arch Surg. 1997;132(10):1124. doi:10.1001/archsurg.1997.01430340078013

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Breast-conserving surgery is the option chosen by 35% to 40% of American women in whom breast cancer was diagnosed. Other than the cosmetic deformity, lumpectomy in itself results in little morbidity. However, axillary node dissection does carry some possible risks: lymphedema; motor nerve damage, specifically damage of the long thoracic nerve of Bell; and damage to the intercostal nerves, leading to numbness of the anterior part of the upper aspect of the arm.

Wilmot et al present their experience with balloon axilloscopy in human cadavers and in a porcine model. They report that this technique, which uses 3 trocars and constant carbon dioxide insufflation, results in excellent visualization of the sensory and motor nerves. The authors state that this technique has several advantages over the open surgical dissection, which include better visualization of the upper part of the axilla and easier identification of the nerves. For patients requiring a level

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