The park-bench position in cervico-facial reconstructive surgery: a technical note.

Area of Science:

• Surgical Oncology
• Plastic and Reconstructive Surgery
• Microsurgery

Background:

• Wide-field tumor resection of the scalp and posterior neck often requires multiple surgical positions, complicating simultaneous reconstruction.
• Simultaneous resection and reconstruction using free flaps for extensive head and neck tumors present significant surgical challenges.

Observation:

• The park-bench position, a lateral oblique patient orientation, was utilized for a patient with microcystic adnexal carcinoma involving the scalp and scapular region.
• This position facilitated both tumor resection and free flap reconstruction without repositioning the patient.
• The transverse cervical vessels were found to be optimally located for microvascular anastomosis in this position.

Findings:

• Reconstruction was successfully achieved using a right latissimus dorsi flap with microvascular anastomoses to the thoracodorsal and transverse cervical vessels.
• The park-bench position allowed for efficient harvesting of the flap and performance of microsurgery in a single operative setting.
• At 8 months post-operatively, the patient showed no signs of local recurrence or distant metastasis, with good flap viability and contour.

Implications:

• The park-bench position is a valuable technique for simplifying complex oncologic resections and free flap reconstructions in the head and neck region.
• This approach can potentially reduce operating time and improve surgical efficiency for challenging tumor cases.
• Further studies could explore the broader application of the park-bench position in various head and neck tumor reconstructions.