Totally Extraperitoneal Endoscope-assisted Deep Inferior Epigastric Perforator Flap Harvest Using an Optical…

Cohort studyPlastic and reconstructive surgery. Global open· Aug 2026

Totally Extraperitoneal Endoscope-assisted Deep Inferior Epigastric Perforator Flap Harvest Using an Optical Trocar.

Ryohei Katsuragi, Keigo Hayashi, Norie Abe … Toshihiko Satake

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Microsurgery & FlapsCohort studyQ1IF 1.8

Optical trocar technique created retrorectus working space in under 4 minutes

Totally Extraperitoneal Endoscope-assisted Deep Inferior Epigastric Perforator Flap Harvest Using an Optical Trocar.

Ryohei Katsuragi … Toshihiko Satake

Plastic and reconstructive surgery · Aug 2026 · Q1 in Surgery

Background

Endoscope-assisted deep inferior epigastric perforator (E-DIEP) flap harvesting enables pedicle dissection through a shorter anterior rectus sheath incision.

Methods

We retrospectively reviewed 10 consecutive patients treated with this technique to assess its feasibility, intraoperative peritoneal breach, conversion to the transabdominal preperitoneal approach, and abdominal wall complications.

n = 10 consecutive patients

3.9

Results

3.9

minutes

space created in under 4 minutes, no conversion to the more invasive approach needed

n = 10 consecutive patients

More results

This can be performed using either a transabdominal preperitoneal (transabdominal preperitoneal) or a totally extraperitoneal (totally extraperitoneal) approach.

The totally extraperitoneal approach is less invasive because it avoids transperitoneal entry.

More results

We developed a simple optical trocar-guided technique to establish a safe retrorectus space for E-DIEP pedicle dissection.

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Conclusion

In this small case series, optical trocar-guided entry into the retrorectus space was considered a feasible approach for establishing a totally extraperitoneal working space during E-DIEP pedicle dissection.

Totally Extraperitoneal Endoscope-assisted Deep Inferior Epigastric Perforator Flap Harvest Using an Optical Trocar.

Totally Extraperitoneal Endoscope-assisted Deep Inferior Epigastric Perforator Flap Harvest Using an Optical Trocar.

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