Endoscopically assisted fascia-saving harvest of rectus abdominis

The rectus abdominis muscle has been widely used for various reconstructive purposes with a high success rate. However, the potential of donor-site morbidity remains a concern to both patients and surgeons. Using endoscopically assisted dissection beneath the anterior rectus sheath, seven free and four pedicled rectus abdominis muscle flaps were harvested by means of a transverse low abdominal incision and a periumbilical incision or a preexisting laparotomy scar. The anterior rectus sheath tension was not disrupted by the traditional longitudinal cut on the anterior sheath. Because this approach preserves the anteroposterior rectus sheath, the abdominal wall tension is less damaged. The scar is also less conspicuous as compared with the conventional harvest technique.