Scarring from previous open abdominal surgery in patients undergoing autologous deep inferior epigastric perforator (DIEP) breast reconstruction has been reported to increase overall flap and donor site complication rates. The evidence to date demonstrates that it can be performed safely although with significantly higher postoperative donor site morbidity. It would seem logical that minimal access laparoscopic surgery is less likely to be associated with increased risks to flap vascularity or donor-site complications; however, there is little evidence available in the literature about the impact of previous laparoscopic surgery to the DIEP harvest site. The typical positions for port placement in standard laparoscopic procedures are usually distant from ideal perforator locations reducing the risk of perforator damage. We present a case of unilateral isolated injury to the proximal deep inferior epigastric artery (DIEA) following previous laparoscopic abdominal surgery in a patient undergoing bilateral mastectomy and breast reconstruction with bilateral free DIEP flaps.
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http://dx.doi.org/10.1136/bcr-2022-250802 | DOI Listing |
J Clin Med
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Department of Plastic, Reconstructive and Aesthetic Surgery and Hand Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), 1011 Lausanne, Switzerland.
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Department of Radiation Oncology, Sharett Institute of Oncology, Hadassah Medical Center, Hebrew University Medical Center, Jerusalem 91120, Israel.
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Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany (N.M., C.L., A.S., A.I., T.D., L.B., D.K., C.C.P., A.L., J.A.L.).
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Division of Plastic and Reconstructive Surgery, DeWitt Daughtry Family Department of Surgery, Miami, FL, USA.
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