Reduction of the DIEP flap donor site morbidity through a minimally invasive pedicle harvest with Jacob's ladder incisions

Publication date: June 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery, Volume 71, Issue 6

Author(s): Laurenz Weitgasser, Amro Amr, Franziska Leandra Reutzsch, Thomas Schoeller

Abstract

Despite the decrease of donor-site morbidity through the introduction of the deep inferior epigastric artery perforator (DIEP) flap as successor of the free transverse rectus abdominis (TRAM) flap, abdominal complications still occur. The etiology of lower abdominal bulging following breast reconstruction with the DIEP flap is still under debate. Most studies estimate the incidence for a postoperative lower abdominal bulging to be between 0.7% and 5%. However, a higher number of undetected and unreported cases is not unusual. The authors present their approach to further reduce the donor site morbidity of the DIEP flap pedicle harvest through minimally invasive Jacob's ladder incisions. The authors aim was to assess the technical feasibility of this minimally invasive pedicle harvest and discuss advantages and disadvantages compared to endoscopic or robotic assisted techniques.