Surgery Spotlight: Breast Reconstruction and Treatment of Lymphedema-Surgery Spotlight: Breast Reconstruction and Treatment of Lymphedema

Surgery Spotlight: Breast Reconstruction and Treatment of Lymphedema

Video Transcription

Video Summary

Dr. Jaume Macià, a professor and chief in plastic surgery at Sampao Hospital, discusses an intricate surgical case involving a combination of perforator flap and lymphatic surgeries. The hospital, recognized as one of the five university hospitals in Barcelona and the oldest active hospital in Europe, undertakes this complex procedure—a bilateral breast reconstruction and treatment for unilateral lymphedema. The patient, initially diagnosed with breast cancer, had undergone a mastectomy and radiotherapy. She later developed lymphedema on her left arm due to chemotherapy for metastatic tumors. This surgery involves a bilateral DAP (Deep Inferior Epigastric Perforator) flap, bilateral lymph node transfer, and lymphovenous anastomosis for the affected side. During the surgery, Dr. Macià highlights the challenges of recreating breast symmetry post-mastectomy and addressing tissue differences caused by prior radiotherapy. The team employs advanced techniques, including ICG (Indocyanine Green) assessment and customized flap designs, ensuring careful consideration of lymphatic health. Ultimately, the surgical team successfully completes the procedure, emphasizing the importance of maintaining precise conditions for optimal outcomes.

Asset Caption

This Surgery Spotlight will provide an in depth look at breast reconstruction and treatment of lymphedema using lower abdominal flaps harvested with attached inguinal lymph nodes performed by Dr. Jaume Masia of Sant Pau University Hospital in Barcelona, Spain.

Upon completion of this video, you should be able to:

Identify pre-operative site markings for: bilateral breast reconstruction, placement of nipples, perforator flap incision, superficial circumflex iliac arteries incision, inguinal lymph nodes and surrounding area incision, and active lymphatic channels.
Explain the importance of using indocyanine green (ICG) to visualize lymphatic flow of lymphatic channels.
List tips and techniques to ensure successful breast reconstruction via perforator flap surgery.

Faculty: Jaume Masia, MD

Keywords

Jaume Masia MD

surgery spotlight

surgical video

breast

reconstruction; Memben

plastic surgery

perforator flap

lymphatic surgery

breast reconstruction

lymphedema treatment

mastectomy

lymphovenous anastomosis

ICG assessment

customized flap designs