Tamer N Abdelbaki, Noureldin Ahmed, Mahmoud Ahmed Alhussini, Moustafa Elshafei. Journal of Minimally Invasive Surgery 2024;27:33-9. https://doi.org/10.7602/jmis.2024.27.1.33

Background: Sentinel lymph node (SLN) has become the gold standard for all cases with no axillary nodal metastasis. The combined radioisotope and blue dye technique is adopted in most centers. The lack of the technology for radioisotope in our institution encouraged us to study the feasibility of methylene blue (MB) for SLN detection in breast cancer patients admitted to Alexandria Surgical Oncology Unit. Methods: A total of 144 cases were subjected to SLN detection by injecting 2 ml of MB 1%. This was followed by standard axillary lymph node dissection. The safety and accuracy of MB as a tracer for detection of SLN were studied. Results: The identification rate was 93.15%. The number of SLN identified ranged from 1 to 8 nodes with a mean of 1.75 ± 1.17. The sensitivity of MB dye technique was 96.3%. The false negative rate was 3.7%. The negative predictive value was 97.6% and the accuracy was 98.5%. Conclusions: MB is a safe, reliable, cheap, and accurate alternative tracer for detection of SLN.

Background: Implant-based breast reconstruction (IBBR) is the predominant reconstructive modality following mastectomy, accounting for more than 80% of all breast reconstruction procedures. Preventing subclinical infection at the time of implant insertion is critical for reducing the incidence of capsular contracture. This study evaluated a simple, cost-effective, flexible, and disposable laparoscopic camera sleeve designed to facilitate the no-touch technique in breast implant insertion. Methods: A prospective study was conducted between November 2021 and September 2025, including all patients undergoing IBBR with the laparoscopic camera sleeve technique. The narrow end of the sleeve was removed and employed as an additional cover for the implant. The prepared sleeve was partially introduced into the pocket, allowing the implant to be inserted without contact with the skin. Results: A total of 42 patients underwent IBBR using smooth round implants, with a mean implant size of 432.85 ± 69.68 ml. Postoperative seroma occurred in seven patients (16.7%), and wound dehiscence in two patients (4.8%). No implant rupture, postoperative infection, or capsular contracture was observed during the follow-up period. Ten patients (23.8%) received adjuvant radiation therapy, with a mean follow-up of 18.87 ± 8.86 months. Conclusion: The use of the laparoscopic camera sleeve provides a simple, cost-effective, and reproducible technique for no-touch insertion of breast implants. The technique substantially reduces skin contact and potential contamination, thereby lowering the risk of postoperative infection and capsular contracture. Level of Evidence III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .