Kay Yoon-Flannery, DO, MPH, FACS, chief of Women’s Oncology at AtlantiCare in Egg Harbor Township, NJ, had observed breast surgeons internationally to learn technique variations for robotic nipple-sparing mastectomy using the da Vinci Single Port (SP) system ahead of bringing the procedure to AtlantiCare Regional Medical Center’s Atlantic City campus.
In this conversation with CancerNetwork®, she discussed where surgeons most often place the single incision required for the procedure, and how that placement affects access to breast tissue as well as the cosmetic result patients see in the mirror afterward. Yoon-Flannery compared the lateral axillary line, her preferred site, with the inframammary approach some surgeons use, and explained the tradeoffs of each, including how robotic arm positioning factors into that choice.
Transcript:
There are differences. I’ve observed a number of surgeons, internationally, to develop this craft as best I could, and there were differences in technique. I will say that the majority of the surgeons I’ve observed typically tend to make an incision in the lateral axillary line, and the advantage there is that it’s away from, for instance, the nipple areolar complex, to hopefully maximize blood flow without any interruption created surgically. It’s also well hidden, usually under the arm, so it’s either hidden under the bra line or by the arm. If patients are looking directly at themselves in the mirror, it would be on the side and wouldn’t be directly visualized. There are other surgeons who traditionally use an inframammary incision, although that’s technically a little less optimal, I should say, because of the positioning of the robotic arms. But I did observe some surgeons using that inframammary incision. For the most part, though, most surgeons are using the lateral axillary line, and that’s what I prefer to do.
Reference
AtlantiCare first in region to offer robotic nipple-sparing mastectomy using da Vinci Single Port system. News release. AtlantiCare Health Network. July 13, 2026. Accessed July 27, 2026. https://tinyurl.com/3w5tz4ux
