OMENTAL FLAP OBTAINED BY LAPAROSCOPIC SURGERY FOR RECONSTRUCTION OF THE CHEST-WALL

The reconstruction of complex defects of the chest wall after infectio n of the sternotomy wound presents a great challenge. Various options have been described for these reconstructions using muscle and omental flaps to fill the space and cover the defect. A. case of reconstructi on of a large defect of the chest cage and abdominal wall in a 62-year -old patient is presented. After surgery for revascularization of the myocardium, the patient developed mediastinitis, osteomyelitis, and ne crosis of the sternum. The pectoralis major muscle was utilized for th e reconstruction, but total loss of the flap occurred. After debrideme nt, an omental flap obtained by laparoscopy was employed based on the left gastroepiploic artery. The omentum was transposed without complic ations through the abdominal wall defect. An overlay skin graft with t he omentum as receptor bed completed the closure. There are advantages in using minimally invasive videolaparoscopy compared with laparotomy in obtaining the omentum, with the same result regarding reconstructi on of the defect.