Laparoscopy in patients following transverse rectus abdominis myocutaneous flap reconstruction.

摘要: Abstract Background: We report our technique and experience performing laparoscopic pelvic surgery on four women after transverse abdominus rectus myocutaneous flap (TRAM). Technique: Examination under anesthesia is performed all patients in the low lithotomy position parallel with floor. The abdominal aorta palpated outlined. A pneumoperitoneum created either by umbilical or left upper quadrant Veress placement. Patients an acceptable location undergo port placement through incision of relocation. Other options include paramedian avoiding ligamentum teres vessels. Lateral operative ports (5 mm) are placed reference to present, pathology, umbilicus. Techniques electrocautery, intra- extracorporeal suturing knot tying, clips preferred minimize size. Experience: Following unilateral bilateral TRAM reconstruction, consecutive breast cancer survivors underwent successful laparoscopic-assisted vaginal hysterectomy oophorectomy using periumbilical for trocar only complication was a superficial skin breakdown from adhesive allergy that required 6 weeks complete resolution. Conclusion: Laparoscopic feasible reconstruction. Knowledge anatomic physiologic variations related procedure necessary planning safe operation.