Minimally invasive harvesting of the latissimus dorsi

The latissimus dorsi has been used extensively and dependably in reconstruction surgery. The major complications involve donor-site infections, seromas, and poor cosmesis. Minimally invasive surgery has been used in abdominal, thoracic, and urologic surgeries with favorable results. To date, flap harvesting and other soft-tissue surgeries have been considered poorly accessible to minimally invasive surgery based on existing techniques. We demonstrate in the cavader model the minimally invasive harvesting of a latissimus dorsi myofascial pedicle flap. This is performed with a laparoscope and commercially available instruments through three small incisions. External traction on the skin elevates the underlying subcutaneous tissues, creating a soft-tissue cavity without insufflation. Donor-site complications may be decreased as a result of less tissue disruption.