Intercostal muscles in the rabbit: surgical anatomy and flap construction

Demos and colleagues (1967) obtained good antireflux results from transposing an intercostal myoneurovascular pedicle around the gastro-oesophageal junction in dogs. An intact neurovascular supply is essential for the viability of a muscle flap. The aim of this study was to delineate the nerve and arterial supply to the left 11th intercostal muscle in the rabbit and to assess whether this muscle could be mobilized as a viable flap. The innervation of the muscle was studied using the methods of gross dissection in cadaveric specimens, and histological staining techniques. The arterial supply was studied using gross dissection, and aortography. In three non-recovery experiments, intercostal muscle was transposed around the gastro-oesophageal junction. The distal motor latency was recorded after electrical stimulation of the intercostal wraps. Gross dissection, histological staining techniques, and aortography showed that the left 11th intercostal muscle group in the rabbit is supplied by segmental vein, artery and nerve, running between external and internal intercostal muscles. Aortography and electrical stimulation demonstrated that the muscle group could be mobilized with an intact neurovascular supply. The left 11th intercostal muscle group has potential as a viable muscle flap for use in surgical procedures within the upper abdomen.