Endoscopic harvest of the rectus abdominis free flap

Balloon dissection in the fascial plane

L. S. Bass, N. S. Karp, Teresa Benacquista, A. K. Kasabian, A. S. Brown, Rauscher, S. P. Bartlett

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Free-flap donor sites are a frequent source of morbidity, including scar deformity and reduced mobility, as well as a significant contributor to recovery time after surgery. We present our technique for endoscopic harvest of the rectus abdominis muscle. A groin crease incision is made, which allows identification of the vascular pedicle and access to the inferior portion of the muscle. A balloon dissection device is inserted along the posterior rectus sheath and inflated. The inferior incision is closed over an endoscopic port after medial and lateral ports are inserted under direct vision at the level of the umbilicus. The cavity is insufflated with carbon dioxide, allowing visualization using a 10-mm, 30-degree endoscope. The remaining dissection is performed sharply, and the muscle is harvested via the groin incision. This technique has proved feasible during study in fresh human cadavers. Insufflation greatly reduces work load with retractors. The balloon device speeds dissection with a minimum of trauma. Because all dissection is performed from within the rectus sheath, the peritoneal cavity is not violated. Endoscopic rectus abdominis harvest using the fascial plane is safe and efficient and carries the potential to reduce donor-site morbidity.

Original languageEnglish (US)
Pages (from-to)274-280
Number of pages7
JournalAnnals of Plastic Surgery
Volume34
Issue number3
DOIs
StatePublished - 1995
Externally publishedYes

Fingerprint

Rectus Abdominis
Free Tissue Flaps
Dissection
Groin
Muscles
Morbidity
Umbilicus
Equipment and Supplies
Insufflation
Endoscopes
Peritoneal Cavity
Workload
Cadaver
Carbon Dioxide
Cicatrix
Blood Vessels
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery

Cite this

Endoscopic harvest of the rectus abdominis free flap : Balloon dissection in the fascial plane. / Bass, L. S.; Karp, N. S.; Benacquista, Teresa; Kasabian, A. K.; Brown, A. S.; Rauscher; Bartlett, S. P.

In: Annals of Plastic Surgery, Vol. 34, No. 3, 1995, p. 274-280.

Research output: Contribution to journalArticle

Bass, L. S. ; Karp, N. S. ; Benacquista, Teresa ; Kasabian, A. K. ; Brown, A. S. ; Rauscher ; Bartlett, S. P. / Endoscopic harvest of the rectus abdominis free flap : Balloon dissection in the fascial plane. In: Annals of Plastic Surgery. 1995 ; Vol. 34, No. 3. pp. 274-280.
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