Abstract
Aim: Immediate breast reconstruction after mastectomy using the latissimus dorsi musculo-cutaneous flap is well recognized. It allows for satisfactory aesthetic results. To minimize scanning in skin sparing mastectomy patients, we used a surgical technique consisting of an endoscopic harvesting of the latissimus dorsi pure muscular flap with a virtual cavity created by CO2 gas distention.Method: Between 9 April 2001 and 30 September 2001, 8 patients underwent latissimus dorsi endoscopic harvesting for an immediate breast reconstruction after skin sparing mastectomy.Result: The mean operating endoscopic time was 112minutes. No open surgical conversion was necessary. The mean lymphatic drainage was 2720ml with removal of the drainage on post operative day 15.Conclusion: The endoscopic harvesting of the latissimus dorsi muscular flap, using a mixed technique of dissection guided by the lighted cleaver forceps and a closed technique by CO2 insufflation using an endoscope is feasible, reproducible and has acceptable morbidity. This technique brings encouraging aesthetic results after skin sparing mastectomy.
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