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Simultaneous Bilateral Microsurgery in Autologous Tissue Breast Reconstruction.

Gaku Tachibana1, Toshihiko Satake1, Minami Noto1

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Summary
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A simultaneous microsurgical approach for bilateral breast reconstruction significantly reduces operative and ischemia times compared to the conventional sequential method. This efficient technique offers a safe and reliable solution for patients needing reconstruction on both sides.

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Area of Science:

  • Microsurgery
  • Plastic Surgery
  • Surgical Oncology

Background:

  • Bilateral autologous breast reconstruction involves complex microsurgery on both sides.
  • This increases operative time and surgeon workload compared to unilateral procedures.

Purpose of the Study:

  • To evaluate the efficacy of a simultaneous microsurgical approach for bilateral breast reconstruction.
  • To determine if this method reduces operative time and surgeon burden.

Main Methods:

  • A comparative study of 22 patients undergoing bilateral breast reconstruction using deep inferior epigastric artery perforator flaps.
  • Patients were divided into conventional sequential and simultaneous microsurgical groups.
  • Simultaneous group involved two surgeons operating concurrently with separate microscopes.

Main Results:

  • The simultaneous group demonstrated significantly shorter operative times (538 vs. 657 minutes, P=0.04).
  • Ischemia times were also significantly reduced in the simultaneous group (92 vs. 177 minutes, P=0.006).
  • No reoperations were required in the simultaneous group; one flap loss occurred in the conventional group due to infection.

Conclusions:

  • The bilateral simultaneous microsurgical approach is effective in reducing operative and ischemia times for breast reconstruction.
  • This method maintains safety and offers an efficient, reliable solution for bilateral procedures.
  • Requires two skilled microsurgeons but optimizes workflow and patient outcomes.