Fig. 1

Schematic diagram of the endoscopic procedure. A The gray shaded area is the body projection of the working area of the endoscopic instruments. A porous water injection needle is used to inject diluted adrenaline solution evenly into the above-mentioned area of the retromammary space. B A tunneler is used to create a surgical cavity in the retromammary space to the underside of the tumor. C A small amount of methylene blue can be injected transdermally around the tumor to aid in localization. D The tumor is progressively dissected from the bottom to the top until the tumor (and the capsule) is removed entirely