Preoperative planning for DIEP breast reconstruction: early experience of the use of computerised tomography angiography with VoNavix 3D software for perforator navigation

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
Marc D PacificoR W Smith

Abstract

The deep inferior epigastric perforator (DIEP) flap is normally the first choice in breast reconstruction; however, due to the considerable vascular anatomical variation and the learning curve for the procedure, muscle-sparing transverse rectus abdominis musculocutaneous (TRAM) flaps are still frequently performed to reduce the rate of complications. Accurate preoperative investigation of the perforators would allow better operative preparation and possibly shorten the learning curve. In an effort to increase accuracy of preoperative planning and to aid preoperative decision-making in free abdominal flap breast reconstruction, we have acquired the use of VoNavix, software that creates three dimensional images from computerised tomography angiography (CTA) data. The use of the VoNavix software for analysis of CTA provides superior imaging that can be viewed in theatre. It, together with CTA, enables decisions to be made preoperatively, including: which side to raise the flap; whether to aim for a medial or lateral row perforator; whether to take a segment of muscle and whether to expect an easy or difficult dissection. We have now performed over 60 free abdominal flap breast reconstructions aided with CTA, and 10 of these cases ...Continue Reading

References

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May 8, 2002·Plastic and Reconstructive Surgery·Marc VandevoortGerd Fabre
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Citations

Nov 17, 2009·Surgical and Radiologic Anatomy : SRA·Jin MeiMaolin Tang
Jan 7, 2014·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Jamie A Kelly, Marc D Pacifico
Apr 4, 2016·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Olivia A HoStefan O Hofer
Mar 29, 2016·The Breast : Official Journal of the European Society of Mastology·Katrin SeidenstueckerPhillip N Blondeel
May 31, 2011·Clinics in Plastic Surgery·Jaume MasiaXavier Alomar
Aug 3, 2010·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Jeroen M SmitPaul M N Werker
Oct 28, 2011·Journal of Magnetic Resonance Imaging : JMRI·Zhitong ZouMartin R Prince
May 31, 2011·Clinics in Plastic Surgery·William J CaseyLuis H Macias
May 31, 2011·Clinics in Plastic Surgery·Maurice Y Nahabedian
Dec 19, 2015·Annals of Plastic Surgery·Adam J BauermeisterMartin I Newman
Dec 20, 2012·Expert Review of Medical Devices·Ergun KocakStephen P Povoski
Dec 22, 2020·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·John KielyRyckie G Wade

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