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 I 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. (C) 2007 Excerpta Medica Inc. All rights reserved.