Immediate breast reconstruction using a laparoscopically harvested omentalflap

Use of an omental flap to reconstruct the br east after cancer surgery was first reported by Kiricuta in 1963. Since then, the omelltum has been widel y used in cancer surgery to cover extensive thoracic defects associated wit h radionecrosis. In contrast, for breast reconstruction or augmentation mam maplasty. rectus abdominis and latissimus dorsi flaps have been used far mo re often than omental flaps. This article describes a new technique for imm ediate breast reconstruction using laparoscopically harvested omentum and r eports the results obtained in 10 patients. Nine patients underwent immedia te breast reconstruction after subcutaneous mastectomy. In the other. patie nt, omentum was used in combination with skin grafting to cover a postmaste ctomy defect. Follow-up exceeded 16 months in the first patients. The resul ts suggest that breast reconstruction using a laparoscopically harvested om ental flap may be extremely dependable ill terms of vascular supply (there was one case of partial necrosis, which healed with local management alone) . The postoperative course of all patients was uneventful, and the use of l aparoscopy reduced the hospital stay to less than T days. Donor-site scars were minimal. There was Ilo residual loss of function, and there were no ca ses of incisional ventral hernia. Cosmetic results weresatisfactor, with a soft breast that was both natural in appearance and stable in volume. Howev er, in two patients the amount of omentum was found to be inadequate during the procedure; consequently, an implant was inserted under the omental fla p. Breast reconstruction using a laparoscopically harvested omental flap is a new technique that allows autogenous reconstruction without disfiguremen t of the donor site and that results in a soft, natural-looking breast.