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Expanding the Criteria for Robotic Deep Inferior Epigastric Perforator Flaps: Case Report With Long Intramuscular
Diwakar Phuyal1, Osama Darras1, Raffi Gurunian2
1From the Integrated Surgical Institute, Cleveland Clinic, Cleveland, Ohio.
Abstract:
Robotic harvest of the deep inferior epigastric perforator flap is gaining traction among plastic surgeons. However, its use is often limited to cases with short intramuscular length of the perforator (<4 cm) due to the need for a larger anterior fascial incision. We present a case of robotic-assisted transabdominal preperitoneal harvest of a 15-cm pedicle, including 9.1 cm intramuscular, through a 3.5-cm fascial incision. The patient had an uneventful intraoperative and postoperative course. Robotic deep inferior epigastric perforator harvest aims to reduce donor-site morbidity but has been limited to cases with a short intramuscular course. Using robotics instead of the open approach for intramuscular course dissection can expand its application by reducing the anterior rectus fascia incision.

