DIEP Flap Breast Reconstruction | Surgery Spotlight-Dissection of the recipient site and vessels

Video Transcription

Video Summary

The video demonstrates a delayed breast reconstruction surgery using a DIEP flap for a woman who previously underwent a left mastectomy and radiation therapy. The surgeon begins by marking the surgical area and carefully dissecting the old mastectomy scar and inframammary fold. Attention is given to preserving healthy subcutaneous fat, which aids in flexibility and healing, especially in radiated tissue. The procedure involves excising the cartilaginous portion of the fourth rib to expose the internal mammary vessels essential for the flap's blood supply. The surgeon emphasizes careful dissection to avoid damaging the thin-walled internal mammary vein, particularly delicate in radiated patients. Techniques include using electrocautery for precise, bloodless cuts and careful peeling of the perichondrium to avoid pneumothorax. The video illustrates detailed steps of rib cartilage removal, vessel exposure, and preparation to inset the DIEP flap, highlighting cautious handling of tissues for optimal reconstruction outcomes.

Keywords

DIEP flap

delayed breast reconstruction

mastectomy

internal mammary vessels

rib cartilage removal

mastectomy scar dissection