Ultra sonic Dissection in Modified Radical Mastectomy

Abstract

Objective: To determine the outcome of ultrasonic dissection in modified radical mastectomy.
Methods: Ninety patients fulfilling the inclusion criteria were selected for study. Modified radical
mastectomy was performed by using the ultrasonic dissector. Flaps were raised using
coagulating shears/blades of ultrasonic dissector and dissection of the breast tissue was done
with same device. Level II axillary clearance was done in all cases. Coaptive coagulation mode
was used to occlude and transect the blood vessels and lymphatic vessels. Two closed suction
drains placed.
Results: All the patients were females with mean age of 45.81±10.02 years. Mean volume of
drainage of pectoral drain was 56 ± 35.45ml, mean volume of drainage of axillary drain was 250 ±
109.07ml, and mean total volume of drainage was 306.39 ± 130ml. The mean duration of drain
was 5.87±1.62 days. There were 4 patients (4.44%) who developed seroma out of total ninety
patients at 10th postoperative day while 86 patients (95.56%) had no clinical signs of seroma.
None of the patients developed wound infection, flap necrosis, or post operative hematoma.
Conclusions: Modified radical mastectomy with axillary dissection using ultrasonic dissection
is safe, feasible and effective. With this technique, there is reduced volume of drainage and
duration and incidence of seroma.