Video-Assisted Harvesting of Anterolateral Thigh Free Flap

Author:

Moreno Mauricio Alejandro1

Affiliation:

1. Department of Otolaryngology, Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

Abstract

Objective To provide a description of a minimally invasive, video-assisted technique (VAT) to identify the cutaneous perforators of the anterolateral thigh (ALT). The objective of the study was to compare this technique with standard open exploration of the thigh and to describe the learning curve for the procedure. Study Design Case series with chart review. Setting Academic tertiary institution. Subjects and Methods Twenty-six cases operated between December 2009 and June 2012. In all of these cases, an open thigh exploration, considered the gold standard, was performed immediately after the VAT. Data retrieved included surgical findings, demographics, and outcomes. Results There were 17 men and 9 women with a mean age of 60 years. The average flap size was 91 cm2 (range, 39-264 cm2), and a chimeric double skin paddle flap was harvested in 6 cases. Forty-nine of 53 total perforators were successfully identified endoscopically. Findings on endoscopic and open exploration were highly correlated ( r = 0.92, P = .000). The overall sensitivity for the technique was 92.4% (confidence interval, 80.9-97.5) but reached 100% for perforators located at the midpoint of the anterior-superior iliac spine–patella line. All flaps survived, and there were no technique-related complications. The learning curve plateaued after 15 cases, with a mean endoscopic operative time of 18.2 minutes for the last 10 procedures. Conclusion This VAT is a safe and reliable method to identify cutaneous perforators of the lateral thigh. The procedure is straightforward and has a moderate learning curve. This approach has a role in minimizing donor site morbidity and assisting in flap design.

Publisher

SAGE Publications

Subject

Otorhinolaryngology,Surgery

Cited by 5 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Anterolateral Thigh Free Flap;Matrix Head and Neck Reconstruction;2023

2. Endoscopic-Assisted Radial Forearm Free Flap Harvest: A Novel Technique to Reduce Donor Site Morbidity;Journal of Reconstructive Microsurgery;2018-06-12

3. Anterolateral Thigh Perforator Flap;Raising of Microvascular Flaps;2017-10-27

4. Preoperative color Doppler ultrasonographic examination in the planning of thoracodorsal artery perforator flap with capillary perforators;Journal of Plastic, Reconstructive & Aesthetic Surgery;2016-03

5. Head and Neck Reconstruction with Chimeric Anterolateral Thigh Free Flap;Otolaryngology–Head and Neck Surgery;2015-09-24

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