Microdochectomy

Microdiscectomy Surgery in Koramangala, Bangalore

The surgical removal of a lactiferous duct is known as microdochectomy. Microdochotomy refers to the simple incision of a mammary duct.

What is Microdochectomy?

The term "microdochectomy" refers to the removal of a breast duct. To locate the origin of the nipple discharge, a probe will be inserted into one of the ducts from the breast drains to the nipple. The discharge-causing region of the breast will then be removed.

There are about 12-15 glandular ducts in the breast that open up to the nipple surface. The breast ducts are affected by several breast diseases.

Who Should Undergo a Microdochectomy?

Patients with nipple discharge should consider microdochectomy, which can be used both as a diagnostic and therapeutic treatment. Intraductal papilloma is the most common cause of the disease, accounting for nearly 80% of cases. This is a benign growth that attaches to the mammary duct wall and is normally located just below the nipple in premenopausal women. A serous or bloody discharge from the nipple is the most common symptom of intraductal papilloma.

What is the Procedure of Microdochectomy?

Galactography, a technique that examines the ductal system of the breast and acts as a map of the ducts to locate the affected one, is used to identify the affected duct before surgery. Preoperatively, the physician can order a variety of tests, including mammography and breast ultrasound.

Gentle pressure is applied to the nipple in the operating room to locate the orifice or opening of the infected duct. A fine probe is carefully placed into the duct as far as possible, ensuring that it is not damaged or disturbed. After that, the duct is dilated, and dye is injected into it to mark it.

The nipple's borders are then traced and incised (circumareolar incision). To produce a skin flap, the areolar skin is lifted. The infected duct is gently dissected and separated from the surrounding tissues for around 5 cm. After that, the duct is transected and removed. A drain may be inserted by certain surgeons, which will be removed after several hours. The incision is stitched closed with absorbable sutures.

When Should You Consult a Doctor?

Microdochectomy is a technique that can be used for both diagnostic and therapeutic purposes. To ascertain the source of the nipple discharge, the specimen is sent for biopsy. Microdochectomy can resolve nipple discharge if only a single duct is involved. If multiple ducts are involved, a more complex procedure, such as a subareolar resection or central duct excision, may be needed. The doctor will go through your medical history and recommend the best possible procedure.

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What is the Expected Recovery after Microdochectomy?

On the day of surgery, the majority of patients return home. For the first 24 to 48 hours, it is recommended that you be accompanied home by a caregiver who will stay with you (or very nearby).

• For the first few days, you can choose to wear a supportive wire-free bra or crop top.
• After general anesthesia, you cannot drive for at least 24 hours.
• For the next four weeks, avoid lifting (over 1 kg), pushing, or dragging – this involves lifting children and housework like vacuuming or hanging out the laundry. For 4-6 weeks, avoid workouts that cause a lot of 'breast bounce', such as jogging or aerobic sessions.

Conclusion

Microdochectomy has proven to be a highly effective surgical procedure that does not compromise the breast's integrity. In certain cases, conservative care with close clinical monitoring of the patient using cytology and ultrasonography may be possible. With nipple surgery, there is always the risk of losing skin over the nipple since the blood supply to the nipple may be compromised during the procedure, resulting in nipple loss.