Periareolar approach in minimally invasive thoracic surgery: a narrative review

Abstract

Driven by the evolving clinical demands of minimally invasive thoracic surgery, innovation in anatomical surgical approaches that promote enhanced perioperative recovery, incision concealment, and pain reduction has become an important direction for future development. As a concealed-incision strategy, the periareolar approach has been applied to a range of thoracic diseases and has shown potential advantages in cosmetic outcomes and postoperative pain control. However, broader clinical adoption remains limited by the lack of unified patient-selection criteria, insufficient standardization of surgical techniques, the risk of areola injury, the technical learning curve, and unresolved perioperative management issues. Moreover, thoracic surgeons’ understanding of this approach remains incomplete. This review summarizes the surgical techniques, clinical applications, practical challenges, and future prospects of the periareolar approach, with the aim of providing a reference for its clinical practice and standardized implementation.