Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Minimally Invasive Surgery - Systemic
Abstract number: 26366
ENDOSOPYCALLY-ASSISTED RAISING OF THORADORSAL FREE FLAPS
Andrey SEREDA 1 , Andrey GRITSYUK 1 , Lyubov GAUER 2 , Natalia BOYARINTSEVA 1
1 National Pirogov Medicine Center, Moscow (RUSSIA), 2 9nth Medicine center,
Ministry of Defence, Moscow (RUSSIA)
Latissimus dorsi and serratus anterior muscle flaps are used most often in
reconstrucive microsurgery. The main disadvantage of this muscle flaps lies in its
donor-site morbidity with the risk of scar contracture and limitation of shoulder
movement. A possible solution to this problem is the endoscopically-assisted
harvesting. We performed an anatomical study (15 cadavers, 30 dissections)
investigating variant anatomy of thoracodorsal artery and its branches according to
minimally invasive endoscopycally-assisted harvesting. Optimal portals for
endoscopically assisted dissection of the blood vessels and approaches were
identified. The appropriate incision located at the anterior border of the latissimus
dorsi muscle with the center located at the level of scapula’s inferior angle should be
5 cm long. That was enough in all cases of variant anatomy we have met.
Endoscopycally-assisted raising of thoracodorsal flaps was performed in 12 patients
(9 - latissimus dorsi and 3 serratus anterior flap). The results were compared with
results of the traditional open technique (retrospective group, 19 patients). Mean time
of harvesting in case of endoscopically-assisted group was 112 min (91 min in the
traditional group, p0.05). Mean DASH score 6 months post operation was 41 in the miniinvasive
group and 52 in the traditional group (p