Single-Site Endoscopic Surgery for Soft Tissue Lesions: An Innovative Technique.

Purpose We aimed to report an innovative single-site endoscopic surgery for soft tissue lesions performed at our center. Methods All patients who underwent soft tissue surgery were reviewed. All consecutive patients who underwent single-site endoscopic surgery between September 2019 and March 2024 were included in the study. Data were extracted from our medical records database, including sex, age, diagnosis, sites of surgery, surgery, operation time, blood loss, and follow-up. Results There were 10 females and five males in the current study, with ages ranging from one year to 26 years (median = nine years). Conditions for surgery included enlargement of the leg (n = 5), fibro-adipose vascular anomaly (n = 4), microcystic lymphatic malformation (n = 3), venous malformation with thrombosis (n = 3), and borderline tumor (n = 2). Surgical sites included the lower extremity (n = 13) and upper extremity (n = 2). Perioperative thrombosis prophylaxis included elastic compression and subcutaneous low-molecular-weight heparin in patients who had venous malformation and localized intravascular coagulopathy for three or more days. Surgery included tumor en bloc resection, tumor partial resection, lymphedema debulking, microcystic lymphatic malformation debulking, limb debulking, intramuscular lesion radical resection, thrombectomy, Achilles lengthening, relaxation of the ankle capsule, gastrocnemius recession, and tendon transfer. Technical success was obtained in all patients. Operative duration ranged from 66 to 455 minutes (median = 183 minutes). Blood loss ranged from 5 to 700 mL (median = 50 mL). One patient received a blood transfusion. Conclusions This retrospective review demonstrates the feasibility of using a single-site endoscopic approach to resection of subcutaneous, muscular and tendinous lesions and proof of principle for future soft tissue surgery.