Endoscopic latissimus dorsi flap harvesting

Abstract 

Background

Immediate breast reconstruction using the latissimus dorsi musculocutaneous flap is a standard technique that allows for cosmetically acceptable results yet leaves a great scar on the donor site. To reduce the scars, we have been using a different surgical technique consisting of endoscopic harvesting of the latissimus dorsi pure muscular flap with a virtual cavity created by CO₂ gas distention.

Methods

Between May 1, 2001, and June 30, 2005, there were 52 patients who underwent latissimus dorsi endoscopic harvesting for an immediate breast reconstruction after a skin-sparing mastectomy.

Results

The mean surgical endoscopic time was 64 minutes. There was one conversion to an open technique. We reported no deaths, but complications included 2 hematomas, 6 inflammatory syndromes, and 1 pulmonary embolism.

Conclusions

The endoscopic harvesting of the latissimus dorsi flap when performed with this mixed technique is feasible, reproducible, and permits a significant reduction of incision size and postoperative pain, with good aesthetic results.

Keywords: CO₂ neocavity, Endoscopy, Latissimus dorsi flap, Immediate breast reconstruction