Laparoscopic Abdominal Surgery after Primary Breast Reconstruction Using an Abdominal Flap

Tsuyoshi Nakagawa,Kentaro Okamoto,Hiroyuki Uetake,Noriko Oshima,Masanori Tokunaga,Yuichi Kumaki,Goshi Oda,Yuya Sato,Noriko Uemura,Toshiaki Ishikawa,Kumiko Hayashi,Hiroki Mori,Kimio Wakana

doi:10.3390/medicina57090952

Tsuyoshi Nakagawa, Kentaro Okamoto + Show 11 more

Open Access

https://doi.org/10.3390/medicina57090952

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Abstract

Background and objectives: Our department has been performing primary breast reconstruction for breast cancer surgery, incorporating a transverse rectus abdominis myocutaneous flap (TRAM)/vertical rectus abdominis myocutaneous flap (VRAM) since 1998 and a deep inferior epigastric artery perforator flap (DIEP) since 2008. Currently, most gastrointestinal operations in abdominal surgery are performed laparoscopically or are robot-assisted. Cases in which abdominal surgery was performed after breast reconstruction using an abdominal flap were reviewed. Method: A total of 119 cases of primary breast reconstruction using an abdominal flap performed in our department were reviewed. Result: The reconstructive techniques were DIEP in 69 cases and TRAM/VRAM in 50 cases. After breast surgery, seven abdominal operations were performed in six cases. In DIEP cases, one robotic surgery was performed for uterine cancer, and one laparoscopic surgery was performed for ovarian tumor. In TRAM/VRAM cases, two laparoscopic cholecystectomies, one laparoscopic total gastrectomy, one laparoscopic ileus reduction, and one open total hysterectomy oophorectomy were performed. Six surgeries were completed by laparoscopy or robotic assistance. Conclusion: The survival rate after breast cancer surgery is improving, and the choice of breast reconstruction procedure should take into account the possibility of performing a prophylactic resection of the ovaries due to the genetic background and possibly postoperative abdominal surgery due to other diseases. However, in cases in which laparoscopic surgery was attempted after breast reconstruction using an abdominal flap, the laparoscopic surgery could be completed in all cases.

Highlights

A total of 119 patients who were diagnosed with breast cancer at our institution from 2018 of underwent primary breast reconstruction by transverse rectus abdominis myocutaneous flap (TRAM)/VRAM
Europe and the United States, it is performed for the correction of rectus diastasis and in Europe and the United States, it is performed for the correction of rectus diastasis obesity, as wellasaswell breast reconstruction
When performing bariatric gery after after abdominoplasty, e.g., e.g., laparoscopic sleeve gastrectomy, there areare difficulties surgery abdominoplasty, laparoscopic sleeve gastrectomy, there difficulties with pneumoperitoneum and the lack of working space, and the number of ports may bebe with pneumoperitoneum and the lack of working space, and the number of ports may increased to compensate for this increased to compensate for this [7,8]

Summary

Introduction

Since the reports of TRAM in 1982 and DIEP in 1994, abdominal autologous breast reconstruction surgery for breast cancer has become a common procedure [1,2]. In Japan, the surgery was somewhat slower to spread. The number of breast cancer cases in. Japan increased in the 2000s, and it is the most common cancer in Japanese women [3]. Our department has been performing primary breast reconstruction for breast cancer surgery since 1998 with TRAM/VRAM reconstruction and since 2008 with DIEP reconstruction. In abdominal surgery, cholecystectomy was mainly performed

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