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Annals of Surgical Oncology

, Volume 26, Issue 10, pp 3216–3223 | Cite as

The “Nipple Whipple”?! A Pilot Study to Assess the Ergonomic Effects of Nipple-Sparing Mastectomy

  • Katherine KopkashEmail author
  • Kevin Novak
  • Kristine Kuchta
  • Irene Yashina
  • Elizabeth Poli
  • Sarah Rabbitt
  • Catherine Pesce
  • David Winchester
  • Katharine Yao
Breast Oncology
  • 64 Downloads

Abstract

Background

Nipple-sparing mastectomies (NSMs) with reconstruction are believed to be more difficult to perform than skin-sparing mastectomies (SSMs), but there is little quantitative data to support this claim.

Methods

This prospective study analyzed four surgeons performing mastectomies. Electromyography (EMG) electrodes placed on selected muscle groups on each surgeon were used to capture muscle exertion intraoperatively and a percentage of maximum voluntary exertion was calculated (%MVE). Data regarding surgeon demographics, exercise habits, musculoskeletal problems, and surgery-specific workload was collected using a questionnaire.

Results

A total of 61 mastectomies were analyzed; 40 were NSM and 21 were SSM/total mastectomies. NSM were considered to be more mentally demanding and physically demanding than SSM (p < 0.001). When the surgeons’ EMG data was analyzed as a group, there was a statistically significant difference in %MVE for NSM versus SSM at high muscle activity in bilateral anterior deltoid muscle groups and at average muscle activity for the left anterior deltoid muscle only. At low muscle activity, there was a statistically significant increase in activation for SSM versus NSM in bilateral cervical erector spinae. Repeated measures ANOVA was performed, which showed statistically significant differences at high muscle activity between NSM and SSM in the left cervical erector spinae and bilateral anterior deltoid muscles.

Conclusions

Our pilot study shows that intraoperative EMGs can assess muscle activity for mastectomy operations and show a difference between NSM and SSM. This is the first study to provide quantitative data on muscle strain with NSM.

Notes

Acknowledgment

The authors thank Jennifer Jaffe for her help with preparing the manuscript and figures for publication.

Disclosure

The authors do not have anything to disclose.

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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Katherine Kopkash
    • 1
    • 2
    Email author
  • Kevin Novak
    • 3
  • Kristine Kuchta
    • 1
  • Irene Yashina
    • 3
  • Elizabeth Poli
    • 4
  • Sarah Rabbitt
    • 1
  • Catherine Pesce
    • 1
    • 2
  • David Winchester
    • 1
    • 2
  • Katharine Yao
    • 1
    • 2
  1. 1.Department of SurgeryNorthShore University HealthSystemEvanstonUSA
  2. 2.Pritzker School of MedicineUniversity of ChicagoChicagoUSA
  3. 3.Department of NeurophysiologyNorthShore University HealthSystemEvanstonUSA
  4. 4.Department of SurgeryUniversity of ChicagoChicagoUSA

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