Introduction/Background Introduction: Moving forward from VNOTES technics in hysterectomy to a concept of No Scar in Breast Surgery and exploring the optimisation of vision in Nipple Skin sparing Mastectomy during prophylactic

Mlastectomy A continuous serie is reported

Methodology Methods: this Is a continuous series of a single institution and a single surgeons study.

25 patients with full validate indications of prophylactic mastectomy underwent for assisted total laparoscopic sKIn sparing mastectomy and immediate reconstruction by a fully trained single surgeon in reconstructive surgery and also fully trained surgeon with more than 400 procédures of laparoscopic abdominal single port ‘ myomectomy, borderline ovarian staging, laparoscopic assisted vaginal hysterectomy)

We are describing our step by step technics the procedure is first described

Dissection of the outter quadrant of the breast with scissors. then we insert the single port and then we follow the procedure with endoscopic assistance and bipolar .

The first sériée of patients was done by single port with assistance of an additionnal 3 mm port the second séries of patients underwent laparoscopic assistance for the dissection of the NAC and inner part of the breast

The last and recent serie of 11 patients underwent fully assisted procedure

The removal of specimen is done in an endobag without morcellation the insertion of the implant is challenging due to the small size of the incision ( less than 2 cm)

Results Results: All the patients underwent a complete procedure without a major operative time.

The procedure is done without additionnal time in comparison to the open technic.

No immediate or Late complication occurs due to the technics patiente satisfaction is good

No conversion

No skin necrosis

No hematoma.

Conclusion Conclusion: The operation is safely feasible more cases are needed to validate that very interesting New technic.

The patient satisfaction is High.

Disclosures No disclosure to declare.