Endoscopic harvest of the rectus abdominis muscle

The rectus abdominis muscle is a versatile muscle with many applications. T he use of this muscle is often limited by its considerable donor site morbi dity. This study reports a minimally invasive technique to harvest the rect us abdominis muscle. The described technique has been used successfully in 5 patients who required a superiorly based flap for reconstruction of a ste rnal defect. All patients have had long-term flap survival and resolution o f their sternal osteomyelitis. Although initially lengthy, harvest times ha ve been less than 1 hour for the last 3 patients. Patients report minimal d iscomfort at their operative site. To date there have been no hernias or ot her complications. The rectus abdominis muscle can be harvested successfull y endoscopically. With no other modification other than port site placement , this technique could be used to harvest free flaps or harvest inferiorly based rectus flaps. This technique is learned easily, is safe, and should r educe substantially the donor site morbidity associated with more tradition al harvesting techniques.