European Journal of Plastic Surgery

, Volume 42, Issue 5, pp 505–508 | Cite as

A novel technique for the safe transfer of the pedicle of a free flap in head and neck reconstruction using a nasopharyngeal airway connected to a negative pressure suction

  • Tamir Shay
  • Lior Har-ShaiEmail author
  • Dean D. Ad-El
  • Aharon Amir
Ideas and Innovations


Microsurgical free flaps are the accepted standard of care for head and neck reconstruction after tumor resection. In many cases, the pedicle of the free flap needs to be tunneled under bone and/or soft tissues to reach the recipient vessels in the site of anastomosis, most often located in the neck. Passing the pedicle through the dissected tunnel is always a blind procedure that increases the risk of shearing, turning, twisting, or kinking and in the worst case disconnection. We hereby demonstrate a novel and simple technique for a safe delivery of the pedicle to the anastomosis site in the neck using a nasopharyngeal airway (nasal airway) connected to negative pressure suction. In all of our cases, no complications were noted during the pedicle delivery to the neck while using this method.

Level of Evidence: Level IV, therapeutic study.


Free flap pedicle Pedicle tunneling Pedicle transfer Nasal airway tube Negative pressure suction Head and neck reconstruction 


Compliance with Ethical Standards



Conflict of interest

Shay Tamir MD, Har-Shai Lior MD, Ad-El Dean D. MD, and Amir Aharon MD declare that they have no conflict of interest.

Ethical approval

Not applicable.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.The Department of Plastic Surgery and Burns, Rabin Medical Center and The Sackler Faculty of MedicineTel Aviv UniversityPetach TikvaIsrael

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