ENDOSCOPIC HARVEST OF THE GRACILIS MUSCLE FLAP

Endoscopic technique is becoming increasing prevalent in plastic surge ry and is being explored for use in tissue harvest for microneurovascu lar transplantation. To advance the art truly, endoscopic technique mu st provide similar success and complication rates, operative time, and ease of performance as the traditional ''open'' surgical harvest. We report the successful microvascular transplantation in 6 patients of g racilis muscles harvested with endoscopic guidance. Dissection of the primary pedicle was done through a small proximal incision, and subseq uent dissection was accomplished with an endoscope through the primary incision and a small distal incision. This method provides excellent success of transfer and decreased morbidity compared with the open tec hnique. Specifically, the resulting scar from the endoscopic technique is considerably smaller, with just a 5-cm proximal and a 1.5-cm dista l scar. The technique is accomplished with standard endoscopic equipme nt and is learned rapidly. We believe the improved aesthetic outcome m akes endoscopic gracilis harvest a preferred technique.