Initial report of extraperitoneal pedicle dissection in deep inferior epigastric perforator flap breast reconstruction using the da Vinci SP

• Published in: Archives of plastic surgery Vol. 49; no. 1; pp. 34 - 38
• Main Authors: Jung, Ji Hyuk, Jeon, Yeo Reum, Lee, Dong Won, Park, Hyung Seok, Lew, Dae Hyun, Roh, Tae Suk, Song, Seung Yong
• Format: Journal Article
• Language: English
• Published: 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA Thieme Medical Publishers, Inc 01.01.2022; Korean Society of Plastic and Reconstructive Surgeons; 대한성형외과학회
• Subjects: breast; Breast/Trunk; deep inferior epigastric perforator; dissection; pedicle; robot; 성형외과학; Breast; Deep inferior epigastric perforator; Pedicle; Robot; Dissection
• ISSN: 2234-6163; 2234-6171
• DOI: 10.5999/aps.2021.00703

The deep inferior epigastric perforator (DIEP) flap has been widely used for autologous breast reconstruction after mastectomy. In the conventional surgical method, a long incision is needed at the anterior fascia of the rectus abdominis muscle to obtain sufficient pedicle length; this may increase the risk of incisional hernia. To shorten the incision, several trials have investigated the use of endoscopic/robotic devices for pedicle harvest; however, making multiple additional incisions for port insertion and operating in the intraperitoneal field were inevitable. Here, we describe the first case, in which a DIEP free flap was successfully made using the da Vinci SP model. Our findings can help surgeons perform operations in smaller fields with a single port in the extraperitoneal space. Moreover, this method is expected to lead to fewer donor-related complications and faster healing.