Endoscopic technique for free flap harvesting.

We have described the current state of development of endoscopic techniques used for harvest of the latissimus dorsi and rectus abdominis muscles, two of the most versatile reconstructive tissue sources available to plastic surgeons. We also have described our clinical experience with harvest of jejunal segments. The potential for the use of these tissues without the conventional pattern of scarring is very exciting. The broader implications for harvesting other donor tissues such as the gracilis, internal oblique, and serratus anterior muscles, and the thoracodorsal and temporalis fascias are on the near horizon. More sophisticated instrumentation is necessary, however, to facilitate the endoscopic approach in the subcutaneous space. This will necessarily include the development of better mechanisms for the creation and maintenance of the optical space. Fortunately, advances in this important technology are occurring month by month as experience and interest heighten, and instrumentation is improved. With increased experience and instrumentation development, it is possible that minimally invasive tissue harvest will become the future standard.