We present an endoscopic nipple-sparing mastectomy with immediate deep inferior epigastric perforator (DIEP) flap reconstruction in a 38-year-old woman with multifocal HER2-positive invasive ductal carcinoma following neoadjuvant chemotherapy. The procedure was performed through a single concealed axillary incision using CO₂ insufflation and endoscopic visualization, allowing controlled dissection with preservation of the skin and nipple–areolar complex. Intraoperative transillumination was used to assess flap thickness and vascularity, while retroareolar frozen section confirmed the absence of malignant involvement. Following mastectomy and axillary clearance, immediate reconstruction was performed using a DIEP flap with microvascular anastomosis to regional recipient vessels. Final histopathology demonstrated a pathological complete response (ypT0 ypN0; RCB-0). The video demonstrates the key technical steps, anatomical landmarks, and principles of combining endoscopic breast surgery with microsurgical autologous reconstruction.

Sign in to write a review

Reviews are open to CSurgeries members. Sign in to share your feedback on this case.

Sign in Don’t have an account? Create one free

Have a question about this case? Send a note to Dr. Pon Jeeva Mathan — they'll reply by email.

Endoscopic Nipple-Sparing Mastectomy with Immediate DIEP Flap Reconstruction After Neoadjuvant Chemotherapy

Become a reviewer

Register today to continue watching

Register today to submit a video

Upgrade your membership to continue watching

Renew your subscription to continue watching

Create An Author

Create A User

Create A Term