Transpelvic Oblique Rectus Abdominis Myocutaneous Flap With Preservation of the Rectus Sheath

Diseases of the Colon and Rectum
César E CanessaRicardo Misa Jalda

Abstract

Perineal reconstructive surgery is an effective procedure to decrease the morbidity associated with extensive abdominoperineal resection in the treatment of advanced low rectal and anal malignancies. Rectus abdominis myocutaneous flaps are often utilized in perineal reconstruction with excellent results. However, the main disadvantages are donor-site morbidity and the need for an open procedure after laparoscopic resection, requiring larger incisions with a resultant increase in postoperative pain. Herein, we describe a modified oblique rectus abdominis myocutaneous flap technique that allows sparing of the rectus sheath and the linea alba. We followed the 3 stages regularly described for the procedure: 1) abdominoperineal resection with simultaneous abdominal and perineal team approach, and removal of the specimen through the perineal wound; 2) right oblique rectus abdominis myocutaneous flap with inferior epigastric pedicle, and release of the rectus muscle from its aponeurotic sheath through the skin paddle incision and transposition of the oblique rectus abdominis myocutaneous flap through an incision in the transversalis fascia; and 3) perineal reconstruction by sutures of the skin paddle to the perineal wound skin edges. ...Continue Reading

References

Jul 28, 2004·Plastic and Reconstructive Surgery·Michael J Lee, Gregory A Dumanian
May 16, 2008·Diseases of the Colon and Rectum·Daniel E AbbottGregory A Dumanian
Jan 23, 2016·Plastic and Reconstructive Surgery·Chris DevulapalliGedge D Rosson

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