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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

Patient 2. Postoperative view 2 months. The esthetic outcome is acceptable since scars of only 3 trocar ports along the anterior axillary line or posterior axillary line and mastectomy incision are visible.
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Figure 4: Patient 2. Postoperative view 2 months. The esthetic outcome is acceptable since scars of only 3 trocar ports along the anterior axillary line or posterior axillary line and mastectomy incision are visible.

Mentions: Neither of the patients developed any complications related to the muscle flap such as flap loss, fat necrosis, seroma formation, or thermal injuries of the skin. Neither patient had scarring of the back or scarring in the axillary aspect, unlike other patients who develop significant scars on the back and axilla after LDMF transfer with the traditional method. The 3 ports created for the trocars along the anterior axillary and posterior axillary lines were barely noticeable, and both the patients and the medical staff found that the appearance of the breast in terms of shape, size, and symmetry was satisfactory (Figs. 3 and 4).


Novel technique for laparoscopic harvesting of latissimus dorsi flap with prosthesis implantation for breast reconstruction
Patient 2. Postoperative view 2 months. The esthetic outcome is acceptable since scars of only 3 trocar ports along the anterior axillary line or posterior axillary line and mastectomy incision are visible.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: Patient 2. Postoperative view 2 months. The esthetic outcome is acceptable since scars of only 3 trocar ports along the anterior axillary line or posterior axillary line and mastectomy incision are visible.
Mentions: Neither of the patients developed any complications related to the muscle flap such as flap loss, fat necrosis, seroma formation, or thermal injuries of the skin. Neither patient had scarring of the back or scarring in the axillary aspect, unlike other patients who develop significant scars on the back and axilla after LDMF transfer with the traditional method. The 3 ports created for the trocars along the anterior axillary and posterior axillary lines were barely noticeable, and both the patients and the medical staff found that the appearance of the breast in terms of shape, size, and symmetry was satisfactory (Figs. 3 and 4).

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