EARLY CLINICAL-EXPERIENCE IN ENDOSCOPIC-ASSISTED MUSCLE FLAP HARVEST

Two cases of endoscopic-assisted muscle harvest for lower extremity re construction are presented. Each case involved resurfacing the distal leg and dorsum of the foot with a split-thickness skin graft over a la tissimus dorsi free flap. An endoscope with a video monitor and modifi ed thoracoscopic instruments were used to assist in the muscle harvest . The principles of endoscopic muscle harvest include an incision long enough to remove the muscle, placed in the least conspicuous area tha t is within the reach of the instrumentation; retraction to optimize t he optical cavity or visual working area; and use of video monitors to allow for coordinated assistance. The decrease in visible scarring is dramatic and represents the primary advantage over open techniques. W e believe that the role of endoscopy will continue to expand as our ex perience increases and technology improves.