Intercostal thorascopic harvesting of the internal mammary artery for supercharging a pedicled rectus abdominis flap.

Abstract

Thorascopic harvesting of the internal mammary artery for supercharging the rectus abdominis pedicled flap for breast reconstruction is presented. The procedure was carried on a woman who had previously undergone a mastectomy and who was obese and a diabetic. The patient underwent a "high" flap delay 2 weeks earlier. At the time of operative transfer and setting, the flap's vascularity was found to be compromised. Instead of turbocharging the deep inferior epigastric pedicle to the irradiated axillary vessels, it was possible to harvest and utilize the internal mammary artery without rib resection for the supercharging, thus saving the flap and reconstruction. The technical aspects, and possible advantages and disadvantages of such a procedure are discussed.