title: Totally implantable vascular access device (TIVAD) placement: a modified technique that takes post-procedure aesthetic aspects into account.
abstract: Major progress has been made in breast cancer reconstruction surgery. The standard technique for totally implanted vascular access device (TIVAD) implantation generally requires an incision for port insertion on the anterior part of the thorax that leaves a scar in the middle of the neckline in patients who have undergone mastectomy with complex breast reconstruction. The aim of this technical note is to report our revised surgical technique for TIVAD placement. In patients with breast cancer, we take a lateralized approach, performing an oblique incision on the lowest part of the deltopectoral groove. This allows us to introduce the port and to place it on the anterolateral part of the thorax, thus avoiding an unaesthetic scar on the anterior part of the thorax. Our modified technique for TIVAD implantation is described.
authors.affiliation: Digestive Surgery Clinic, Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Rue H. Bordet, 1, 1000, Brussels, Belgium. gabriel.liberale@bordet.be.
authors.forename: Gabriel
authors.identifier: http://orcid.org/0000-0001-8051-1588
authors.initials: G
authors.lastname: Liberale
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery*; D002405:Catheterization, Central Venous / Q000295:instrumentation* / Q000379:methods; D002408:Catheters, Indwelling; D002921:Cicatrix; D004954:Esthetics; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000295:instrumentation* / Q000379:methods; D000072836:Surgical Wound / Q000517:prevention & control; D062666:Vascular Access Devices
keywords: Breast cancer; Cosmesis; Satisfaction; TIVAD