Endoscopic latissimus dorsi flap harvesting.

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.