When the breast has been removed for cancer and the remaining skin on the chest has been radiated the optimal choice for autologous reconstruction is to use tissue from the lower abdomen.The deep inferior epigastric artery perforator flap or DIEP flap is a variation of the TRAM flap. (drbriandickinson.com)
Simultaneous Circumferential Body Lift and Four-Flap Breast Reconstruction Using Deep Inferior Epigastric Perforator and Lumbar Artery Perforator Flaps. (amedeo.com)
The DIEP flap-like the TRAM flap-requires an incision into the abdominal (rectus) muscle, as the blood vessels, or perforators, required to keep the tissue alive lie just beneath or within this muscle. (wikipedia.org)
After the skin, tissues and perforators (collectively known as the "flap") have been dissected, the flap is transplanted and connected to the patient's chest using microsurgery. (wikipedia.org)
Background Perforators are typically found in rows in the deep inferior epigastric perforator (DIEP) flap. (thieme-connect.de)
As methods to assess flap perfusion continue to improve, surgeons may be more likely to select perforators traditionally avoided. (thieme-connect.de)
The purpose of this article is to describe clinical outcomes based on row and number of perforators to reevaluate flap and abdominal donor site morbidity. (thieme-connect.de)
The deep inferior epigastric perforator (DIEP) flap is commonly used in breast reconstruction and is based on the perforating branches of the deep inferior epigastric artery (DIEA). (thieme-connect.de)
Deep inferior epigastric artery perforator (DIEP) flap reconstruction is one of the newer tissue methods of tissue flap reconstruction. (georgiaplastic.com)
He explains a procedure called DIEP [Deep Inferior Epigastric Artery Perforator] Flap Reconstruction and another called TRAM [Transverse Rectus Abdominus Myocutaneous] Flap Reconstruction," says Marcs in the show, "where they take the fat from either your stomach or your back, and make your new breasts out of that. (amny.com)
Before and after right skin-sparing mastectomy for invasive ductal carcinoma with immediate deep inferior epigastric perforator (DIEP) flap reconstruction and left mastopexy. (medscape.com)
One such procedure is deep inferior epigastric artery perforator (DIEP) flap reconstruction, so-called because it uses a 'flap' of muscle, usually taken from your belly. (cromwellhospital.com)
The superficial inferior epigastric artery (SIEA) flap allows for harvest of the lower abdominal fatty tissue based on the superficial inferior epigastric system. (penelopethemovie.com)
A further advancement in flap surgery came in the 1990s, with the introduction of perforator flaps. (medscape.com)
An example of this is the deep inferior epigastric perforator (DIEP) flap , which has now become the criterion standard in breast reconstruction. (medscape.com)
With the SIEA perforator flap technique, Dr. Howard also makes an incision in the lower abdominal area where skin, fat, and blood vessels are excised. (drmichaelhoward.com)
The DIEP flap (superficial inferior epigastric perforator) is similar to a DIEP flap, except that blood vessels in the belly are moved along with the fat and skin, and the abdominal muscles are spared. (dramitmulay.com)
This flap is based on the perforators of the deep inferior epigastric artery that are maximally centered on the periumbilical region 1. (jotsrr.org)
Robotic-assisted deep inferior epigastric artery perforator flap abdominal harvest for breast reconstruction: A case report. (musc.edu)
INTRODUCTION: Venous congestion burdens up to 15% of deep inferior epigastric artery perforator (DIEP) flap breast reconstructions. (bvsalud.org)
A deep inferior epigastric artery perforator (DIEP) flap takes skin and tissue from the lower abdomen to reconstruct the breast. (atlplasticsurgeon.com)
Free tissue transfer or free flap refers to a procedure in which the blood supply (through vein and artery) and tissue is surgically removed from the donor site on the body and transferred to a recipient site for the purpose of reconstruction. (plasticsurgeryelpaso.net)
DIEP/SIEA (deep inferior epigastric perforator/superficial inferior epigastric artery) flap: Skin and tissue is removed from the lower abdominal midsection. (plasticsurgeryelpaso.net)
LAP (lumbar artery perforator) flap: Tissue will be transferred by the surgeon from the upper buttock or lower back. (plasticsurgeryelpaso.net)
PAP (profunda artery perforator) flap: Donor tissue will be taken from below the buttock or back of the inner thigh. (plasticsurgeryelpaso.net)
Deep inferior epigastric perforator artery (DIEP) is similar to the TRAM Flap, except no muscle is being used to reconstruct the breast. (psda-va.com)
SUMMARY: Perforator flaps have the advantages of reduced donor-site morbidity, versatility to accurately replace the components required at the recipient site, a longer pedicle than is achievable with the parent musculocutaneous flap, and freedom from orientation of the pedicle. (elsevierpure.com)
2 The purpose of this study was to assess the suitability of the porcine abdomen as a training model for the deep inferior epigastric artery perforator (DIEAP) flap, commonly used in human breast reconstruction. (unimore.it)
All steps of a DIEAP harvest were simulated: superficial vein harvest, suprafascial perforator dissection, intramuscular perforator harvest with preservation of the nerves, and flap isolation. (unimore.it)
We isolated a lateral perforator first and a medial one last: the latter was eventually used to nourish the flap (Fig. 2). (unimore.it)
CONCLUSIONS The DSEAP flap allows one to closely reproduce all the steps of DIEAP flap harvesting and also to carry out the intramuscular dissection of 2 perforators for each side (up to 4 for each animal), confirming the adequacy of this pig model for microsurgical training. (unimore.it)
Move tissue from the buttocks or abdomen by creating a DIEP (Deep Inferior Epigastric Perforator) or SGAP (Superior Gluteal Artery Perforator) flap. (soodcenter.com)
This video depicts the microvascular anastomosis of the deep inferior epigastric artery and vein to the internal mammary artery and vein in an anterograde fashion for a delayed bilateral deep inferior epigastric perforator (DIEP) flap reconstruction in a 53-year-old female patient status post bilateral mastectomy for breast cancer. (csurgeries.com)
2 The Deep Inferior Epigastric Perforator (DIEP) flap has now become the most common autologous approach to breast reconstruction. (csurgeries.com)
Background The purpose of this study was to compare the anatomical features of the internal mammary vessels (IMVs) at the second and third intercostal spaces (ICSs) with regard to their use as recipient vessels in deep inferior epigastric artery perforator (DIEP) flap breast re-construction. (ewha.ac.kr)
Tissue from the patient's abdomen, buttocks or thigh region are harvested to form breasts.Deep Inferior Epigastric Artery Perforator (DIEP) Flap, Latissimus Dorsi Myocutaneous Flapand Transverse Rectus Abdominus Myocutaneous (TRAM) Flap are consider Autologous Tissue Flap technique options. (emoryhealthcare.org)
Myo-cutaneous flap with dorsi-muscle or rectus abdominal muscle has been frequently used during last years.However, myo-cutaneous rectus abdominal flap has been replaced with free-flaps, particularly with the development of Deep Inferior Epigastric Artery Perforator (DIEP). (clinicofsurgery.org)
Blood flow to the tissue is supplied by the deep inferior epigastric artery and vein which are divided in the groin and the TRAM flap completely detached from the patient (fig. 1). (beautifulabc.com)
Figure 1: The free TRAM flap gets its normal blood flow from vessels coming from the groin (the inferior epigastric artery and vein). (beautifulabc.com)
Figure 1: The muscle-sparing free TRAM flap gets its normal blood flow from the same vessels coming from the groin (the inferior epigastric artery and vein). (beautifulabc.com)
Background: The deep inferior epigastric perforator flap (DIEP) is the current standard of care in autologous breast reconstruction. (umanitoba.ca)
The newer superficial inferior epigastric artery flap (SIEA) is felt to be an improvement as it does not damage the abdominal wall. (umanitoba.ca)
It is a Mathis and Nahai type V muscle flap with the thoracoacromial artery as the major blood supply and intercostal perforators arising from the internal thoracic artery providing a segmental blood supply. (medscape.com)
Flaps16
Noncontrast MRI is now used for preoperative mapping of perforator flaps. (medscape.com)
Deep Inferior Epigastric Artery Perforator flaps do not need a piece of muscle. (bethechoice.org)
A Head-to-Head Comparison of the Medial Sural Artery Perforator and Radial Forearm Free Flaps for Partial Glossectomy Reconstruction. (memc.com.sg)
Understand the history and controversies surrounding perforator flaps. (elsevierpure.com)
2. Describe the anatomy and understand the theories surrounding the physiology of perforator flaps. (elsevierpure.com)
3. Understand the uses of perforator flaps in reconstruction. (elsevierpure.com)
Many articles now attest to the safety and reliability of perforator flaps. (elsevierpure.com)
This review aims to outline the history and controversies surrounding perforator flaps and to describe the anatomy of the "workhorse" perforator flaps and their use in microsurgical reconstruction. (elsevierpure.com)
These flaps include the deep inferior epigastric artery, the anterolateral thigh, the thoracodorsal artery, and the superior and inferior gluteal artery perforator flaps. (elsevierpure.com)
A case report chart review was conducted on a breast cancer patient who underwent autologous breast reconstruction with deep inferior epigastric artery perforator (DIEP) flaps. (peertechzpublications.org)
Animal model training is less widespread for perforator flaps, although these flaps represent a technical challenge. (unimore.it)
Venous congestion and blood flow in free transverse rectus abdominis myocutaneous and deep inferior epigastric perforator flaps. (beautifulabc.com)
Discussion: perfusion-related complications are similar for DIEP and muscle-sparing free TRAM flaps harvested on medial or lateral deep inferior epigastric artery branch perforators for breast reconstruction. (beautifulabc.com)
Dr. Light explained that Free Transverse Rectus Abdominis Muscle (TRAM) flaps, Muscle Sparing TRAM flaps, Deep Inferior Epigastric Perforator (DIEP) flaps, and Superficial Inferior Epigastric Artery (SIEA) flaps were the most common abdominal free flaps used for breast reconstruction. (nybra.com)
SIEA2
On the contralateral side, the superficial inferior epigastric artery (SIEA) and the superficial inferior epigastric vein (SIEV) are demonstrated. (penelopethemovie.com)
The SIEA, a superficial inferior epigastric artery blood vessel, is present underneath the lower abdomen skin. (dramitmulay.com)
Reconstruction1
Deep Inferior Epigastric Perforator (DIEP) breast reconstruction is an advanced microsurgery procedure that rebuilds the shape of a breast compromised during a mastectomy. (drmichaelhoward.com)
The inferior epigastric vein drains into the external iliac vein near its lower end just above the inguinal ligament. (penelopethemovie.com)
Materials and Methods: Pre-pectoral tissue expanders were removed with a total capsulectomy, and the internal mammary vein and artery were exposed after pectoral division and cartilaginous 3rd rib removal. (csurgeries.com)
Venous anastomosis between the deep inferior epigastric (DIE) vein and internal mammary vein was facilitated through use of a venous coupler. (csurgeries.com)
Results CT angiographic analysis revealed the mean diameter of the deep inferior epigastric artery to be 2.42±0.27 mm, while that of the deep inferior epigastric vein was 2.91±0.30 mm. (ewha.ac.kr)
The tissue is transferred to the chest wall where both the artery and vein are reconnected to similar vessels, either in the armpit (thoracodorsal vessels) or beside the sternum (internal mammary vessels). (beautifulabc.com)
Profunda artery perforator1
A profunda artery perforator is a blood vessel that runs through the thigh. (drmichaelhoward.com)
Abdominal5
There was no difference in fat necrosis or abdominal morbidity between single and multiple perforators. (thieme-connect.de)
Selecting perforators is a balance of achieving adequate perfusion while minimizing abdominal wall morbidity from the dissection. (thieme-connect.de)
The inferior epigastric vessels give off several branches that supply the skin and muscles of the anterior abdominal wall, the deep structures of the abdominal wall and the spermatic cord. (penelopethemovie.com)
The inferior epigastric artery (IEA) is a major blood vessel that supplies the anterior abdominal wall. (penelopethemovie.com)
It arises inferior to the inguinal ligament and courses superiorly to emerge on the anterior abdominal wall. (penelopethemovie.com)
Lateral5
1 ] Medial or lateral row perforators correspond to the originating trunk. (thieme-connect.de)
The deep inferior epigastric artery arises from the external iliac artery and runs from lateral to medial under the rectus muscle. (penelopethemovie.com)
During its course above the arcuate line, the inferior epigastric artery is reflected on the parietal peritoneum as bilateral raised ridges called the lateral umbilical folds. (penelopethemovie.com)
The superior epigastric artery gives lateral as well as medial branches and also it anastomoses around 4 cm above the umbilicus along with sections of the inferior epigastric artery. (earthslab.com)
The perforators are lined in 2 rows: 1 lateral and 1 medial, as in the DIEAP, and the intercostal nerves cross the vessels, as happens in humans. (unimore.it)
Microsurgical1
The location and number of perforators is commonly discussed as a topic for microsurgical optimization. (thieme-connect.de)
Abdomen3
DIEP stands for the deep inferior epigastric perforator artery, which runs through the abdomen. (wikipedia.org)
While the traditional DIEP procedure uses a specific area of tissue and arteries from the abdomen, there are other approaches for women with different body types and different needs. (drmichaelhoward.com)
DIEP, Deep Inferior Epigastric Perforator Artery, is found in the abdomen. (dramitmulay.com)
Medial1
The superior epigastric artery goes into the medial posterior side of the rectus abdominis muscle and also passes through the posterior rectus sheath at the back of the seventh costal cartilage. (earthslab.com)
DIEA1
Perforator location is related to branch patterns described by Moon and Taylor of the DIEA coursing within the rectus sheath superior to the arcuate line. (thieme-connect.de)
Anastomosis3
Where does the inferior epigastric artery anastomosis end? (penelopethemovie.com)
Arterial anastomosis between the DIE artery and internal mammary artery was achieved through handsewn, simple interrupted sutures. (csurgeries.com)
Yamamoto T, Yamamoto N, Hayashi A , Koshima I. Supermicrosurgical deep lymphatic vessel-to-venous anastomosis for a breast cancer-related arm lymphedema with severe sclerosis of superficial lymphatic vessels. (lymphedema.tokyo)
Arcuate line1
At the same time a section of external iliac artery, the inferior epigastric artery , by coming in front of the arcuate line moves in the sheath. (earthslab.com)
Anatomy2
Il est le fondateur et président de la société Augmented Anatomy, une startup qui a développé une technologie révolutionnaire pour mettre en évidence les différences anatomiques en réalité augmentée. (drhendrickx.com)
Hij is oprichter en voorzitter van het bedrijf Augmented Anatomy, een startup die een revolutionaire technologie ontwikkeld heeft om de anatmische verschillen in het gelaat te brengen in Augmented reality. (drhendrickx.com)
However, the blood vessels that are harvested are superficial, rather than deep, which allows Dr. Howard to access these resources without disturbing the muscle. (drmichaelhoward.com)
Rectus muscle1
These arteries circulate the rectus muscle and also anastomose along with each other inside the sheath. (earthslab.com)
Branch3
T he inferior epigastric artery is a branch of the external iliac artery. (penelopethemovie.com)
The superficial epigastric artery is a small branch of the femoral artery. (penelopethemovie.com)
Anatomical1
The aim of the current study was to provide clinicians, surgeons, and obstetricians with sufficient anatomical data on the inferior epigastric artery, such as its origin and branching pattern. (penelopethemovie.com)
Deformity1
Patient satisfaction rate regarding "breast shape" (p = 0.021), "lower pole appearance" (p = 0.00017), and "scar" (p = 0.047) were higher in group A. CONCLUSION: NIC-based pedicle proved to be a safe procedure and allowed us to overcome limitations that typically characterise the inferior pedicle, i.e., 'bottoming-out' deformity, hypertrophic scar of the lower pole, and squaring of the breast contours. (bvsalud.org)
Underwent1
METHODS: Forty breasts underwent NIC-based breast reduction (group A), and 37 underwent traditional inferior-central pedicles (group B). The NIC pedicle was drawn with a width of 3.5-4.5 cm. (bvsalud.org)
Reconstructions1
DIEP reconstructions utilize perforator veins- the smaller more superficial veins that travel from deeper veins and through muscles, to nourish the outer layers of our tissue, like fat and skin. (drmichaelhoward.com)
Fascia1
These ligaments run throughout the breast tissue parenchyma from the deep fascia beneath the breast and attach to the dermis of the skin. (medscape.com)
Internal3
The superior epigastric artery emerges around the sixth or seventh costal cartilage and is a section of internal thoracic artery . (earthslab.com)
The internal mammary artery (A.k.a Internal thoracic artery ) generates the superior epigastric artery along with the musculophrenic artery by dividing below the costal cartilage of the sixth rib. (earthslab.com)
Their development has followed our understanding of the blood supply from a source artery to the skin, which has been achieved because of landmark studies by Manchot, Salmon, Milton, Taylor, and others. (elsevierpure.com)
Superior7
It terminates at the level of the umbilicus by anastomosing with the superior epigastric artery. (penelopethemovie.com)
The artery ends at the level of the umbilicus where it anastomoses with the superior epigastric artery. (penelopethemovie.com)
The superior epigastric artery by entering the gap between the costal and xiphoid slips at the start of the diaphragm goes inside the rectus and also enters deep to the rectus abdominis . (earthslab.com)
The first large perforator that is often referred to as the superficial superior epigastric arter y is oftentimes produced by this artery at the costal margin. (earthslab.com)
The superior epigastric artery afterwards creates branches inside the rectus abdominis muscle and creating choke anastomoses or often a true arterial attachment on or around the level of the midpoint among the xiphisternum and umbilicus , proceeds caudally to connect with an equivalent member of the deep inferior epigastric artery. (earthslab.com)
The deep superior epigastric artery is dominant in pigs. (unimore.it)
Optimal1
Advancing methods to assess perfusion will allow a more precise selection of the optimal perforator. (thieme-connect.de)
Surgeons1
For this reason, surgeons may be interested in venturing away from strict algorithms and selecting perforators traditionally avoided. (thieme-connect.de)
Outcomes1
This study aimed to verify if the narrow inferior-central (NIC) septum-based pedicle can allow the surgeon to improve aesthetic outcomes compared with the traditional inferior-central pedicle approach. (bvsalud.org)
Left1
Left subclavian artery and right subclavian artery. (earthslab.com)
Runs1
The artery gives off several small branches as it runs from the external iliac artery to the muscle (see Figure 5.5). (penelopethemovie.com)
System2
Occasionally, the flow from the superficial system may be more robust than that of the deep inferior epigastric system. (penelopethemovie.com)
This perforator bears no resemblance to the superficial inferior epigastric artery and is created by the deep system. (earthslab.com)
This activity over the course of time inhibits the blood flow to a person's organs as well as tissues and can cause serious health risks induced by atherosclerosis , which is a certain type of arteriosclerosis caused by the accumulation of fatty plaques , cholesterol , along with other substances inside and above the artery walls. (earthslab.com)
Atherosclerosis is a certain type of arteriosclerosis where an artery wall enlarges because of expansion of intimal-smooth-muscle cell generating an atheromatous (which contains fiber and lipid) plaque and infiltration and collection of white blood cells . (earthslab.com)