UNLABELLED One of the main steps in perforator flap surgery is to identify the dominant perforator. Using multidetector row computed tomography (MDCT) for the preoperative planning of deep inferior epigastric artery perforator (DIEAP) flap surgery, we identified a perforator with a large caliber, an excellent location in the middle abdominal region, and a totally extramuscular trajectory in a s...

University of Manitoba, Winnipeg, Manitoba Correspondence: Dr Edward W Buchel, University of Manitoba, GC 404, 820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9. E-mail [email protected] The majority of autologous free flap breast reconstruction uses tissue from the lower anterior abdominal wall. Traditionally, this involved harvesting the entire ipsilateral or bilateral rectus abdominus muscles...

BACKGROUND/AIMS The gastroesophageal junction is an important barrier against gastroesophageal ref lux. Endoscopic grading of gastroesophageal f lap valve is simple, reproducible, and may predict reflux activity. We investigated the correlation between gastroesophageal flap valve grade and the gastroesophageal junction's structural properties using abdominal computed tomography. METHODS A tot...

BACKGROUND Reconstruction of irradiated pelvic defects following oncologic resection requires dead-space obliteration to reduce wound healing complications. Although the vertical rectus abdominis myocutaneous (VRAM) flap is often the best option for pelvic reconstruction following abdominoperineal resection or pelvic exenteration, donor- and recipient-site complications are common. The authors ...

The tremendous variability of the inferior epigastric arterial system makes accurate imaging of the vasculature of the anterior abdominal wall an essential component of optimal perforator selection. Preoperative imaging of the abdominal vasculature allows for preoperative perforator selection, resulting in improved operative efficiency and flap design. Abdominal wall perforators of 1-mm diamete...

Permanent fecal abdominal stomas significantly decrease quality of life. Previous attempts to create continent stomas by using dynamic myoplasty procedures have resulted in disappointing outcomes, primarily owing to denervation atrophy of the muscle flap that was used in the creation of the sphincter and because of muscle fatigue resulting from continuous electrical stimulation that is received...

BACKGROUND The incidence of bilateral mastectomies is increasing along with the rates of breast reconstructions. A substantial number of patients will present with abdominal scars after Cesarean section, laparoscopy, laparotomy, and so on. The aim of this study was to evaluate the impact of prior abdominal scars on complication rates in abdominal bilateral free flap breast reconstruction. MET...

The number of breast reconstruction procedures has been increasing in recent years. One of the suggested treatment methods is breast reconstruction with a pedicled skin and muscle TRAM flap (transverse rectus abdominis muscle - TRAM). Surgical incisions performed during a cholecystectomy procedure may be located in the areas significant for flap survival. The aim of this paper is to present ana...

OBJECTIVE Donor site hernias are a rare but well recognised complication of deep inferior epigastric perforator (DIEP) flap breast reconstruction but there are no reported cases of epigastric hernias after such surgery. We report three patients who developed symptomatic epigastric hernias within 2-8 months after discharge from follow-up. PATIENTS AND METHODS Patients who were referred to the ...

BACKGROUND The advent of lipoplasty has led plastic surgeons to significantly modify the techniques used in performance of abdominoplasty. Such changes have achieved marked improvement in aesthetic results. OBJECTIVE The authors report their experience in performing combination abdominoplasty and lipoplasty, with particular emphasis on means of reducing complications and obtaining the best re...