INTERCOSTAL THORASCOPIC HARVESTING OF THE INTERNAL MAMMARY ARTERY FORSUPERCHARGING A PEDICLED RECTUS-ABDOMINIS FLAP

Thorascopic harvesting of the internal mammary artery for superchargin g the rectus abdominis pedicled flap for breast reconstruction is pres ented. The procedure was carried on a woman who had previously undergo ne a mastectomy and who was obese and a diabetic. The patient underwen t a ''high'' flap delay 2 weeks earlier. At the time of operative tran sfer and setting, the flap's vascularity was found to be compromised. Instead of turbocharging the deep inferior epigastric pedicle to the i rradiated 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 po ssible advantages and disadvantages of such a procedure are discussed.