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Volume 10 Journal of Cancer Science & Therapy
ISSN: 1948-5956 Breast Cancer 2018
May 10-11, 2018
May 10-11, 2018 | Frankfurt, Germany
7th World Congress on Breast Cancer
Immediate breast reconstructionwith laparoscopic harvested omental flap after breast cancer surgery
P Sandbichler
Hospital St. Vinzenz Zams, Austria
Introduction: We present here a rarely used technique for breast reconstruction after complete or subtotal subcutaneous
mastectomy for breast cancer utilizing a laparoscopically harvested omental flap.
Indication: The procedure was performed in selected patients with multicentric carcinomas, large, central tumors (also post
treatment with neoadjuvant chemotherapy), tumors with extensive intraductal component, diffuse ductal carcinoma in situ
(DCIS), and in patients desiring the procedure. To date, 58 procedures (37 complete and 21 partial mastectomies) have been
performed.
Surgical Procedure: After the sentinel node biopsy, laparoscopy was performed in order to estimate the size of the omentum.
The omentum was dissected, preserving the right gastroepiploic vessels as the pedicle of the omental flap. After performing the
subcutaneous mastectomy through an inframammary incision, a subcutaneous tunnel was created, and the omentum pulled
out through a 2 to 3 cm paraxiphoidal incision, and placed within the breast defect.
Results: The cosmetic result was excellent to satisfactory in the majority of cases. There was one loss of the omental flap due
to fat necrosis, and one gastric perforation was managed laparoscopically. In five patients an additional augmentation with
lipofilling became necessary. Small skin necroses could be conservatively treated. Postoperative irradiation in patients with
positive lymph nodes and subtotal mastectomy was performed without complications. There was no local recurrence to date.
Summary: In selected patients, this technique produces good results creating a breast with a natural, soft consistency, and with
minimal donor site morbidity. It provides an esthetically appealing supplement to the established methods. Difficulties include
preoperative estimation of the size of the omentum, however initially inadequate volume frequently increases within the first
6 months. The technique can only be applied for unilateral reconstruction.
Biography
P Sandbichler has completed Medical studies and Doctorate at the Medical University of Innsbruck from 1975–1981. He completed his Surgical residency at the
University Hospital Innsbruck, Department for Visceral and Transplant Surgery from 1982–1990. He is a Managing Senior Physician for Surgery at the Hospital Hall
near Innsbruck from 1990-2000. He is a Professor of Surgery, 1997. He is the Head of the Surgical Department in the Hospital St. Vinzenz, Zams since January
2000. His focus is on oncologic and laparoscopic surgery.
P Sandbichler, J Cancer Sci Ther 2018, Volume 10
DOI: 10.4172/1948-5956-C2-126