Minimally Invasive Approach to Access Vessels for Microvascular Anastomosis in Head and Neck Reconstruction

Area of Science:

• Microsurgery
• Head and Neck Reconstruction
• Vascular Surgery

Background:

• Microvascular free tissue transfer is crucial for reconstructing complex head and neck defects.
• Identifying suitable recipient vessels is a critical step in successful microvascular reconstruction.
• Minimally invasive techniques aim to improve the efficiency and safety of vessel identification.

Purpose of the Study:

• To describe the minimal access technique for recipient vessel identification in microvascular tissue transfer.
• To review the indications for using this approach.
• To evaluate the outcomes and complication rates associated with the minimal access technique.

Main Methods:

• Retrospective chart review of patients undergoing microvascular reconstruction using the minimal access technique between 2015 and 2021.
• Analysis of 236 cases across 214 patients.
• Inclusion of data on defect sites, indications, donor sites, utilized vessels, and complication rates.

Main Results:

• The minimal access technique was applied in 236 cases for various head and neck defects, including mandible, cranium, and maxilla reconstructions.
• Common indications included head and neck cancer extirpation and osteoradionecrosis.
• The overall complication rate was 14%, with flap failure in 3.4%. Prior surgery increased recipient site complication risk.

Conclusions:

• Minimal access techniques provide consistent recipient vessel identification for microvascular free tissue transfer.
• These approaches are suitable for a wide range of head and neck defects.
• The technique is associated with low morbidity and contributes to shorter hospital stays.