Subcutaneouscopic surgery in Children.

Bethany Slater, MD, Ashwin Pimpalwar, MD, FRCS, Pediatric, surgery

Division of Pediatric Surgery, Michael E Debakey Department of Surgery, Baylor college of medicine and Texas Children’s Hospital, Houston, Texas.

Background: Subcutaneouscopic surgery is the use of minimally invasive endoscopic approach for subcutaneous conditions. This cosmetic approach allows placement of incisions in locations remote to the lesion allowing it to be hidden from view. It also allows the advantage of endoscopic magnification and visualization to be used for subcutaneous dissection.

Purpose: To report our experience with the above technique.

Method: We retrospectively reviewed our experience in 5 patients. 2 patients had trans-axillary subcutaneouscopic sternomastoid release for sternomastoid tumor/torticollis. 2 had subcutaneouscopic excision of external angular dermoid cyst via a scalp incision and one had a transaxillary subcutaneouscopic excision of a fibroadenoma of the breast.

Technique: Procedure is performed with 3mm instruments and telescope. Using a Kittner dissector and the foley balloon catheter space is created subcutaneously. Once adequate space is created we use 3mm step ports. CO2 insuffulation was then used to create a subcutaneous space to perform the procedure. The mass is circumferentially dissected free using the hook electrocautery under vision. In lesions over the face only deeper retractors may be used.

Results: There were no complications apparent. The final results at 3 month follow up revealed aesthetically pleasing skin incisions that healed well and were hidden from view.

Conclusion: Subcutaneoscopic surgery in children is safe effective and cosmetic technique. It has the advantage of endoscopic visualization and magnification for subcutaneous dissection. It should be considered for excision of benign subcutaneous lesions in children.

Session: Poster Presentation

Program Number: P555

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