Experimental Basis for Endoscopic Harvesting of Tissues

Abstract

The mere reduction of scars, afforded by endoscopic techniques, is not an advantage unless the results are equal to or surpass those attained with open techniques with equal or less morbidity. However, one clear indication for the use endoscopic techniques is minimal incision tissue harvest. Application of any new technology requires an understanding of basic principles and mastery of fundamentals. In endoscopic plastic surgery it is essential that the surgeon has the necessary training, has the mechanical equipment and skills to perform these procedures, is familiar with methods for troubleshooting, and is thoroughly grounded in safety measures. Understanding these basics will save the practitioner time and frustration, shorten the learning curve, and establish a reference to widen the range of applications. The latissimus dorsi muscle, rectus abdominus muscle and other long muscles can be endoscopically harvested if the overlying skin is not required for the reconstruction. Tissues like nerves, veins or others grafts can be endoscopically harvested with benefits of the reduction of scarring and morbidity. With the help of a two-dimensional (2D) endoscope benefits of minimal invasive microsurgery or open microsurgery through the endoscope, the wrongly called “video-assisted microsurgery”, were described in 1995 entitled “endoscopic Microsurgery”. Since 1996 advantages of three-dimensional (3D) endoscopy are being realized. The vision of this article is to simulate the clinical approach in the future concentrating on endoscopic microsurgery in reconstructions of subcutaneous free tissues.

This study was performed in 1995 at the Division of Plastic, Reconstructive and Maxillofacial Surgery, Emory University Hospital, 1327 Clifton Road, North East Atlanta, Georgia 30322, USA