Paula Escobar

74 statements · 2 topics

Featured statements

▶ Ep 3 · 10:41
since this is uh super visualized and magnified in a screen in the OR everybody is watching what I'm doing so the way I'm handling the mastectomy skin flap is probably is much better because I have a better visualization.
quote · Breast Cancer
▶ Ep 3 · 3:03
we take the breast uh inside out, uh, imagine taking the pillow from a pillowcase, so we keep, we just keep the pillowcase and we remove the pillow.
quote · Breast Cancer
▶ Ep 2 · 10:41
Endoscopic technique may be better than conventional because the magnified screen visualization allows better handling of the mastectomy skin flap and improved visualization of breast tissue behind the nipple and axillary tail.
opinion · Breast Cancer Surgery: Modern Techniques and Outcomes
▶ Ep 2 · 4:10
Minimally invasive breast surgery started in Asian countries approximately 20 years ago using mechanical arms to lift the breast, but early attempts had complications in skin flaps and nipples due to limited technology.
clinical · Breast Cancer Surgery: Modern Techniques and Outcomes

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Paula's statements about Breast Cancer 37 statements

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Endoscopic nipple-sparing mastectomy: minimally invasive breast cancer surgery

▶ Ep 3 · 1:26
clinical 1999 was the first nipple-sparing mastectomy reported. ↗
▶ Ep 3 · 1:32
clinical Dr. Crowe at Cleveland Clinic was one of the pioneers who developed the open/conventional nipple-sparing mastectomy technique. ↗
▶ Ep 3 · 1:53
clinical Endoscopic nipple-sparing mastectomy uses the same technique as conventional nipple-sparing mastectomy but with different tools (minimally invasive approach with less scarring). ↗
▶ Ep 3 · 2:35
clinical The incision is placed in the mid-axillary line hidden by the arm or in the submammary fold, making it completely invisible. ↗
▶ Ep 3 · 2:49
clinical The procedure involves inflating/expanding the breast with CO2, then introducing laparoscopic instruments through a single incision to remove breast tissue while preserving the envelope. ↗
▶ Ep 3 · 3:03
quote we take the breast uh inside out, uh, imagine taking the pillow from a pillowcase, so we keep, we just keep the pillowcase and we remove the pillow. ↗
▶ Ep 3 · 3:28
clinical Immediate breast reconstruction is attempted at the time of mastectomy, with plastic surgeons adjusting their technique to work through the smaller incision. ↗
▶ Ep 3 · 4:07
clinical The current endoscopic technique has approximately 5 years of history in its present form. ↗
▶ Ep 3 · 4:07
quote This technique, the way we do it right now, probably has like. 5 years ↗
▶ Ep 3 · 4:10
quote minimally invasive surgery has started, uh, I would say it started like in the Asian countries like 20 years ago, but they didn't have the technology that we do right now ↗
▶ Ep 3 · 4:10
clinical Minimally invasive breast surgery started in Asian countries approximately 20 years ago using mechanical arms to lift the breast, but early attempts had complications in skin flaps and nipples due to limited technology. ↗
▶ Ep 3 · 4:35
clinical The technique developed in Europe (France, Spain, Italy) using CO2 insufflation and is now being learned in the US. ↗
▶ Ep 3 · 5:10
epidemiological Very few surgeons in the US currently perform endoscopic nipple-sparing mastectomy, making it difficult for patients to access. ↗
▶ Ep 3 · 5:23
clinical Three hands-on simulated model courses have been held in the US to train surgeons in the technique. ↗
▶ Ep 3 · 5:40
quote here at the Cleveland Clinic we're pioneering this technique. ↗
▶ Ep 3 · 5:47
clinical Cleveland Clinic has trained multiple surgeons in the endoscopic technique, with Dr. Escobar helping to train colleagues. ↗
▶ Ep 3 · 6:16
clinical Robotic breast surgery takes a long time, requires a robot, has a long learning curve, and is not FDA approved (currently only available in trials at limited US centers). ↗
▶ Ep 3 · 6:16
quote robotic surgery is great for the breast, but it takes a long time. You need a robot. The learning curve is not short and it's not FDA approved right now. ↗
▶ Ep 3 · 6:36
clinical Endoscopic surgery uses instruments already available for abdominal/hernia surgery, requiring no special equipment purchases. ↗
▶ Ep 3 · 6:43
quote all the instruments and and the things we're using as instruments in the OR are already available because they're using it for abdomen surgery, for hernia, so everything is there, so we didn't have to buy anything in particular at the clinic to start doing it ↗
▶ Ep 3 · 7:04
clinical Operating time for endoscopic surgery, when experienced, is similar to open/conventional surgery. ↗
▶ Ep 3 · 7:40
clinical Indications for endoscopic nipple-sparing mastectomy are very similar to conventional nipple-sparing mastectomy. ↗
▶ Ep 3 · 7:46
clinical Patients are not good candidates if tumor involves the skin, is very close to the muscle, is very close to the nipple, or involves the skin. ↗
▶ Ep 3 · 8:45
clinical Best candidates have cup A, B, or C breasts (not larger breasts at current learning curve stage). ↗
▶ Ep 3 · 8:59
clinical Procedure is performed on patients with no ptosis or ptosis grade 1 or 2, as higher grades result in poor cosmetic outcomes. ↗
▶ Ep 3 · 9:26
clinical Patient advantages include superior cosmetic outcome, hidden/invisible scar, and likely quicker recovery with less pain (similar to laparoscopic vs open abdominal surgery). ↗
▶ Ep 3 · 9:51
clinical Preliminary studies suggest patients have better sensation in the nipple and mastectomy skin flap, though quality trials are needed. ↗
▶ Ep 3 · 10:09
clinical Initial patients have been very happy with the procedure and recovered very quickly. ↗
▶ Ep 3 · 10:26
clinical Oncological safety of conventional nipple-sparing mastectomy has been proven by data. ↗
▶ Ep 3 · 10:41
opinion Endoscopic technique may be better than conventional because the magnified screen visualization allows better handling of the mastectomy skin flap and improved visualization of breast tissue behind the nipple and axillary tail. ↗
▶ Ep 3 · 10:41
quote since this is uh super visualized and magnified in a screen in the OR everybody is watching what I'm doing so the way I'm handling the mastectomy skin flap is probably is much better because I have a better visualization. ↗
▶ Ep 3 · 11:34
clinical No insurance coverage problems have occurred; procedure is coded as skin-sparing mastectomy since no specific code exists yet. ↗
▶ Ep 3 · 11:56
clinical Cleveland Clinic has performed endoscopic nipple-sparing mastectomy with endoscopically-assisted sentinel node retrieval through a single incision. ↗
▶ Ep 3 · 12:12
clinical Future applications include axillary dissection and lumpectomy for tumors in inner portions of the breast (scar in axilla instead of breast). ↗
▶ Ep 3 · 12:24
clinical The technique has been used for gynecomastia surgery in one male patient. ↗
▶ Ep 3 · 12:49
opinion Dr. Escobar predicts widespread adoption will occur similar to laparoscopic cholecystectomy, driven by patient experience, outcomes, and faster recovery. ↗
▶ Ep 3 · 13:32
quote I think this is the era of minimally invasive surgery and breast is going to be part of it. ↗
Paula's statements about Breast Cancer Surgery: Modern Techniques and Outcomes 37 statements

Open the Breast Cancer Surgery: Modern Techniques and Outcomes collection →

Endoscopic nipple-sparing mastectomy: minimally invasive breast cancer surgery

▶ Ep 2 · 1:26
clinical 1999 was the first nipple-sparing mastectomy reported. ↗
▶ Ep 2 · 1:32
clinical Dr. Crowe at Cleveland Clinic was one of the pioneers who developed the open/conventional nipple-sparing mastectomy technique. ↗
▶ Ep 2 · 1:53
clinical Endoscopic nipple-sparing mastectomy uses the same technique as conventional nipple-sparing mastectomy but with different tools (minimally invasive approach with less scarring). ↗
▶ Ep 2 · 2:35
clinical The incision is placed in the mid-axillary line hidden by the arm or in the submammary fold, making it completely invisible. ↗
▶ Ep 2 · 2:49
clinical The procedure involves inflating/expanding the breast with CO2, then introducing laparoscopic instruments through a single incision to remove breast tissue while preserving the envelope. ↗
▶ Ep 2 · 3:03
quote we take the breast uh inside out, uh, imagine taking the pillow from a pillowcase, so we keep, we just keep the pillowcase and we remove the pillow. ↗
▶ Ep 2 · 3:28
clinical Immediate breast reconstruction is attempted at the time of mastectomy, with plastic surgeons adjusting their technique to work through the smaller incision. ↗
▶ Ep 2 · 4:07
clinical The current endoscopic technique has approximately 5 years of history in its present form. ↗
▶ Ep 2 · 4:07
quote This technique, the way we do it right now, probably has like. 5 years ↗
▶ Ep 2 · 4:10
quote minimally invasive surgery has started, uh, I would say it started like in the Asian countries like 20 years ago, but they didn't have the technology that we do right now ↗
▶ Ep 2 · 4:10
clinical Minimally invasive breast surgery started in Asian countries approximately 20 years ago using mechanical arms to lift the breast, but early attempts had complications in skin flaps and nipples due to limited technology. ↗
▶ Ep 2 · 4:35
clinical The technique developed in Europe (France, Spain, Italy) using CO2 insufflation and is now being learned in the US. ↗
▶ Ep 2 · 5:10
epidemiological Very few surgeons in the US currently perform endoscopic nipple-sparing mastectomy, making it difficult for patients to access. ↗
▶ Ep 2 · 5:23
clinical Three hands-on simulated model courses have been held in the US to train surgeons in the technique. ↗
▶ Ep 2 · 5:40
quote here at the Cleveland Clinic we're pioneering this technique. ↗
▶ Ep 2 · 5:47
clinical Cleveland Clinic has trained multiple surgeons in the endoscopic technique, with Dr. Escobar helping to train colleagues. ↗
▶ Ep 2 · 6:16
clinical Robotic breast surgery takes a long time, requires a robot, has a long learning curve, and is not FDA approved (currently only available in trials at limited US centers). ↗
▶ Ep 2 · 6:16
quote robotic surgery is great for the breast, but it takes a long time. You need a robot. The learning curve is not short and it's not FDA approved right now. ↗
▶ Ep 2 · 6:36
clinical Endoscopic surgery uses instruments already available for abdominal/hernia surgery, requiring no special equipment purchases. ↗
▶ Ep 2 · 6:43
quote all the instruments and and the things we're using as instruments in the OR are already available because they're using it for abdomen surgery, for hernia, so everything is there, so we didn't have to buy anything in particular at the clinic to start doing it ↗
▶ Ep 2 · 7:04
clinical Operating time for endoscopic surgery, when experienced, is similar to open/conventional surgery. ↗
▶ Ep 2 · 7:40
clinical Indications for endoscopic nipple-sparing mastectomy are very similar to conventional nipple-sparing mastectomy. ↗
▶ Ep 2 · 7:46
clinical Patients are not good candidates if tumor involves the skin, is very close to the muscle, is very close to the nipple, or involves the skin. ↗
▶ Ep 2 · 8:45
clinical Best candidates have cup A, B, or C breasts (not larger breasts at current learning curve stage). ↗
▶ Ep 2 · 8:59
clinical Procedure is performed on patients with no ptosis or ptosis grade 1 or 2, as higher grades result in poor cosmetic outcomes. ↗
▶ Ep 2 · 9:26
clinical Patient advantages include superior cosmetic outcome, hidden/invisible scar, and likely quicker recovery with less pain (similar to laparoscopic vs open abdominal surgery). ↗
▶ Ep 2 · 9:51
clinical Preliminary studies suggest patients have better sensation in the nipple and mastectomy skin flap, though quality trials are needed. ↗
▶ Ep 2 · 10:09
clinical Initial patients have been very happy with the procedure and recovered very quickly. ↗
▶ Ep 2 · 10:26
clinical Oncological safety of conventional nipple-sparing mastectomy has been proven by data. ↗
▶ Ep 2 · 10:41
opinion Endoscopic technique may be better than conventional because the magnified screen visualization allows better handling of the mastectomy skin flap and improved visualization of breast tissue behind the nipple and axillary tail. ↗
▶ Ep 2 · 10:41
quote since this is uh super visualized and magnified in a screen in the OR everybody is watching what I'm doing so the way I'm handling the mastectomy skin flap is probably is much better because I have a better visualization. ↗
▶ Ep 2 · 11:34
clinical No insurance coverage problems have occurred; procedure is coded as skin-sparing mastectomy since no specific code exists yet. ↗
▶ Ep 2 · 11:56
clinical Cleveland Clinic has performed endoscopic nipple-sparing mastectomy with endoscopically-assisted sentinel node retrieval through a single incision. ↗
▶ Ep 2 · 12:12
clinical Future applications include axillary dissection and lumpectomy for tumors in inner portions of the breast (scar in axilla instead of breast). ↗
▶ Ep 2 · 12:24
clinical The technique has been used for gynecomastia surgery in one male patient. ↗
▶ Ep 2 · 12:49
opinion Dr. Escobar predicts widespread adoption will occur similar to laparoscopic cholecystectomy, driven by patient experience, outcomes, and faster recovery. ↗
▶ Ep 2 · 13:32
quote I think this is the era of minimally invasive surgery and breast is going to be part of it. ↗