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Novel technique for laparoscopic harvesting of latissimus dorsi flap with prosthesis implantation for breast reconstruction

View Article: PubMed Central - PubMed

ABSTRACT

Backgroud:: An important drawback of the traditional technique for harvesting latissimus dorsi (LD) myocutaneous flap is a long, posterior donor-site incision. Current techniques involve endoscopic or robotic harvesting via a combined approach of open and closed surgery, which necessitates an open axillary incision and the use of special retractors. In this paper, we introduce a fully enclosed laparoscopic technique for harvesting LD flap (LDF) using only 3 small trocar ports. This technique eliminates the need for axillary and donor-site incisions and specialized retractors and considerably reduces the incision size.

Methods:: We performed laparoscopic harvesting of LDF with prosthesis implantation for immediate breast reconstruction (IBR) after nipple-sparing mastectomy in 2 patients with malignant breast neoplasm who wished to avoid a long scar on the back.

Results:: IBR using this technique was uneventful in both cases, without any donor-site complications or flap failure. Both patients were satisfied with the esthetic results of the procedure, especially the absence of a visible scar on the back.

Conclusion:: Enclosed laparoscopic harvesting of LDF is simpler and less invasive than the traditional methods. These preliminary results warrant further evaluation in a larger population to validate the benefits of this technique.

No MeSH data available.


Related in: MedlinePlus

Laparoscopic instruments are in place. After trocar placement, a zero-degree endoscope is introduced in the right trocar; an electrocautery apparatus in the middle trocar; and grasper in the left trocar. CO2 is insufflated at a pressure of 10 mm Hg as dissection proceeds.
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Figure 2: Laparoscopic instruments are in place. After trocar placement, a zero-degree endoscope is introduced in the right trocar; an electrocautery apparatus in the middle trocar; and grasper in the left trocar. CO2 is insufflated at a pressure of 10 mm Hg as dissection proceeds.

Mentions: After NSM, the breast incision is closed temporarily, and the patient's position is changed from supine to prone. The trocars are then placed at the marked points: a zero-degree endoscope is introduced in the upper trocar; the electrocautery apparatus (Hangzhou Kangji Medical Instruments Co., Ltd.), in the middle trocar; and a grasper (Hangzhou Kangji Medical Instruments Co., Ltd.), in lower trocar opening (Fig. 2). CO2 insufflation is applied at a pressure of 10 mm Hg to maintain the patency of the optical cavity.


Novel technique for laparoscopic harvesting of latissimus dorsi flap with prosthesis implantation for breast reconstruction
Laparoscopic instruments are in place. After trocar placement, a zero-degree endoscope is introduced in the right trocar; an electrocautery apparatus in the middle trocar; and grasper in the left trocar. CO2 is insufflated at a pressure of 10 mm Hg as dissection proceeds.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120942&req=5

Figure 2: Laparoscopic instruments are in place. After trocar placement, a zero-degree endoscope is introduced in the right trocar; an electrocautery apparatus in the middle trocar; and grasper in the left trocar. CO2 is insufflated at a pressure of 10 mm Hg as dissection proceeds.
Mentions: After NSM, the breast incision is closed temporarily, and the patient's position is changed from supine to prone. The trocars are then placed at the marked points: a zero-degree endoscope is introduced in the upper trocar; the electrocautery apparatus (Hangzhou Kangji Medical Instruments Co., Ltd.), in the middle trocar; and a grasper (Hangzhou Kangji Medical Instruments Co., Ltd.), in lower trocar opening (Fig. 2). CO2 insufflation is applied at a pressure of 10 mm Hg to maintain the patency of the optical cavity.

View Article: PubMed Central - PubMed

ABSTRACT

Backgroud:: An important drawback of the traditional technique for harvesting latissimus dorsi (LD) myocutaneous flap is a long, posterior donor-site incision. Current techniques involve endoscopic or robotic harvesting via a combined approach of open and closed surgery, which necessitates an open axillary incision and the use of special retractors. In this paper, we introduce a fully enclosed laparoscopic technique for harvesting LD flap (LDF) using only 3 small trocar ports. This technique eliminates the need for axillary and donor-site incisions and specialized retractors and considerably reduces the incision size.

Methods:: We performed laparoscopic harvesting of LDF with prosthesis implantation for immediate breast reconstruction (IBR) after nipple-sparing mastectomy in 2 patients with malignant breast neoplasm who wished to avoid a long scar on the back.

Results:: IBR using this technique was uneventful in both cases, without any donor-site complications or flap failure. Both patients were satisfied with the esthetic results of the procedure, especially the absence of a visible scar on the back.

Conclusion:: Enclosed laparoscopic harvesting of LDF is simpler and less invasive than the traditional methods. These preliminary results warrant further evaluation in a larger population to validate the benefits of this technique.

No MeSH data available.


Related in: MedlinePlus