Endoscopic Rectus Abdominis Muscle Harvesting – Experimental Study

Alexandru I Blidisel, Assistant Professor MD PHD, Lucian P Jiga, Associated Professor MD PHD, Octavian Cretu, Professor, Razvan Tirziu, MD Phd, Mihai Ionac, Professor. University Of Medicine and Pharmacy from Timisoara, Romania

 
Aim: The rectus abdominis muscle is one of the most frequent used free flaps in reconstructive surgery. Endoscopic harvesting of free flaps is increasingly used in reconstructive surgery due to minimal donor site morbidity. The present study aims in establishing a comparison between the experimental model of the rectus abdominis muscle endoscopic harvesting technique and the open harvesting technique in pigs.
Material and Method: The study was conducted on 10 pigs with an average weight of 25-30 kg. 5 muscle were harvested by endoscopic technique and 5 muscle through the open technique After orotracheal intubation and anesthesia, a 4-5 cm incision is made in the inguinal plica and prolonged to the lateral margin of the caudal segment of the rectus abdominis muscle. Laparoscopic surgery instruments were used along with the Emory retractor The anterior and posterior side of the muscle is dissected using a forceps and a Hook. After the muscle is sectioned using the hook, the pedicle is isolated and clipped on the desired length. The work chamber is created using Emory retractors.
Results: Operating time was 110 minutes for the open technique and 150 minutes with the endoscopic technique. During the study, the rate of conversion, bleeding, surgery duration, flap viability, length and aspect of the pedicle and moment of mobilization were followed. One pedicle was damaged during endoscopic surgery with following seroma development. Morbidity was lesser in animals where endoscopic harvesting was performed.
Conclusions: Endoscopic harvesting of the rectus abdominis muscle leads to minimal donor site complications. At the same time, this techniques represents an excellent training model for developing endoscopic and open flap harvesting skills.

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