GelPOINT single-incision access with yellow enhancement imaging for endoscopic gynecomastia surgery.

INTRODUCTION

Standard endoscopic gynecomastia surgery, while offering better cosmetic outcomes than open procedures, is often hindered by suboptimal visualization of the glandular-adipose interface, instrument clashing due to multiple concealed ports, and the risk of nipple-areolar complex (NAC) ischemia. This paper describes a technical modification using a single-incision platform and advanced imaging to overcome these limitations.

METHODS

The authors utilize the GelPOINT Mini platform for single-site access through a concealed 3-cm incision behind the anterior axillary fold. To enhance visualization, the VISERA ELITE III Yellow Enhancement (YE) imaging system is employed. This technology brightens fat-rich yellow tissues, allowing for a clearer distinction between the glandular tissue and overlying fat. This technique is specifically indicated for Simon Grade IIa-IIb patients with firm glandular tissue and minimal skin excess.

RESULTS

The single-incision approach eliminates instrument clashing and poor triangulation associated with multi-port techniques. The use of YE imaging facilitates a more precise dissection in the plane beneath the NAC, reducing the risk of vascular compromise, residual pathology, and contour irregularities.

CONCLUSION

The integration of a single-port platform with Yellow Enhancement imaging offers a refined approach to endoscopic gynecomastia surgery. By improving visualization and ergonomics, this modification enhances surgical precision and aesthetic outcomes while minimizing visible scarring.