Microsurgical Training Curriculum in a gynecological breast cancer center – a benefit for patients and surgeons?

Abstract

Purpose Autologous breast reconstruction improves patient satisfaction and quality of life after mastectomy. In Germany, free flap surgery and implant-based reconstruction is usually separate between reconstructive surgery and gynaecology. Cooperation between the specialist disciplines and implementation of microsurgery into breast surgeon training could enhance surgical treatment for breast cancer patients. Methods At the breast cancer center at Klinikum rechts der Isar, TU Munich, a three-stage training program for autologous breast reconstruction and microsurgery for gynecological breast surgeons was developed. Between 2019 and 2022 74 women received autologous free flap breast reconstruction by a consistent team consisting of a gynaecological surgeon in training and an expert microsurgeon. Peri- and postoperative data were collected to analyse the feasibility and safety of a microsurgical training in gynaecology. Results Within the training, operative steps of free autologous breast reconstruction were increasingly taken over by the gynaecological surgeon in training. The analysis showed a decrease in operating times with consistently low complication rates during the training. Conclusion This study demonstrated that a training in free autologous breast reconstruction for gynaecological surgeons is safely feasible through close cooperation between gynaecological and reconstructive surgery.