Endoscopically assisted sural nerve harvest in infants

Area of Science:

• Pediatric Surgery
• Neurosurgery
• Microsurgery

Background:

• Peripheral nerve grafting is crucial for pediatric reconstructive surgery.
• Traditional nerve harvest methods can result in significant donor site scarring.
• Minimizing donor site morbidity is essential in infant surgery.

Purpose of the Study:

• To describe a novel endoscopic technique for sural nerve harvest.
• To evaluate the efficacy and safety of endoscopic sural nerve harvesting in infants.
• To assess the cosmetic outcomes and patient morbidity associated with the endoscopic approach.

Main Methods:

• Endoscopic sural nerve harvest using three small incisions (2 cm each).
• Utilized a 4-mm, 18-cm telescope with a 0-degree lens and video camera.
• Nerve dissection performed under tourniquet control with blunt dissection.

Main Results:

• Successfully performed in over 200 pediatric patients since 1994.
• Common indication: obstetrical brachial plexus palsy.
• No nerve graft injuries observed; minimal postoperative pain, swelling, and ecchymosis.

Conclusions:

• Endoscopic sural nerve harvest is a safe and effective technique for infants.
• The procedure significantly reduces donor site scarring, yielding satisfactory cosmetic results.
• Long-term sensory loss is typically undetectable by patients, highlighting the technique's functional preservation.