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Procurement for a Vascularized and Reinnervated Abdominal Wall Allotransplantation

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Free and pedicled appendix transfer for various reconstructive procedures.

Shih-Heng Chen¹, Eng Kean Yeong, Yueh-Bih Tang

¹Division of Plastic and Reconstructive Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.

Annals of Plastic Surgery

|November 16, 2012

Summary

The appendix, a structurally ideal conduit, can be reliably used in free or pedicled flaps for various reconstructions, including voice, urethra, cervix, and vagina, with successful functional and structural outcomes.

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Area of Science:

Surgical Reconstruction
Organ Transplantation
Appendiceal Anatomy

Background:

The appendix possesses constant vascularity and a patent lumen, making it structurally suitable for use as a conduit.
Previous studies have utilized the appendix in urologic surgeries for urethral reconstruction.
This study explores broader reconstructive applications of the appendix.

Purpose of the Study:

To evaluate the efficacy of appendix tissue transfer in various reconstructive surgeries.
To explore the versatility of the appendix as a free or pedicled flap.
To assess functional and structural outcomes of appendix-based reconstructions.

Main Methods:

Retrospective analysis of 11 patients from 2002 to 2011.
Utilized 8 free appendix transfers and 3 pedicled flaps.
Applications included voice reconstruction (tracheoesophageal fistula), male urethral reconstruction, and female genital tract reconstruction (cervix, vagina).

Main Results:

All 11 cases demonstrated successful structural and functional results.
Voice reconstruction yielded fair to excellent intelligibility and loudness with no aspirations.
Urethral reconstruction resulted in smooth micturition; cervix/vagina reconstruction offered long-term patency up to 2.5 cm diameter.

Conclusions:

The appendix is a reliable autograft for reconstructing conduit-like organs due to its vascularity and structure.
Incorporating adjacent bowel segments enhances length and reconstructive possibilities.
Free and pedicled appendix transfers are applicable and reliable, with minimal morbidity upon removal.