Modified radical mastectomy using harmonic scalpel

BACKGROUND AND OBJECTIVES: Modified radical mastectomy (MRM) remains the most commonly performed surgery for breast cancer today. Conventional surgery using scalpel and electrocautery is associated with moderate blood loss and morbidity in the form of haematoma, flap necrosis, prolonged axillary drainage, and seroma. This study was performed to evaluate the feasibility of using ultrasonic energy (harmonic scalpel) for MRM and to standardise the operative technique of harmonic scalpel MRM using various available accessories of the harmonic scalpel. METHODS: Fourteen patients suffering from carcinoma breast planned for MRM were included in the study. RESULTS: The learning curve of harmonic scalpel MRM was short. Harmonic scalpel is a multifunctional instrument and the whole operative procedure could be accomplished with the currently available accessories. No sutures or electrocautery were used. The mean blood loss was 57.5 ml and the mean operative time was 117 min. There were no hematomas or flap necroses, whereas one patient developed seroma. The mean postoperative drainage volume was 430 ml. CONCLUSIONS: In comparison to the historical data of conventional mastectomy, there seems to be a reduction in the blood loss and drainage volume using harmonic scalpel. Results of our study show that modified radical mastectomy using the harmonic scalpel is feasible and the learning curve is short, however, further studies are needed to assess the impact on morbidity.