Neovaginal reconstruction with a rectus abdominis myocutaneous flap

Benson, Cooper; Ap, Soisson; Carlson, Jay W.; Culbertson, G; Hawley-Bowland, C; Richards, Florence Harvey

doi:10.1016/0020-7292(94)90103-1

Cited by 12 publications

(14 citation statements)

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“…Extension laterally along the costal margin obliquely provides a larger skin island when needed. 37,38 The conventional description delivers the f lap into the pelvis through a transpelvic route. A sensory innervated f lap can be fashioned by preserving the eighth intercostal nerve for anastomosis to the pudendal nerve.…”

Section: The Rectus Abdominismentioning

confidence: 99%

Reconstruction of the Perineum

Wong

2014

Annals of Plastic Surgery

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The pelvic and perineal regions are affected by a heterogeneous spectrum of pathologies, many with a tendency to recur. Extensive mutilation carries physical, sexual, and psychological sequelae. Primary reconstruction reduces morbidity and shortens recovery. Modern management calls for a multidisciplinary approach. Not uncommonly, patients come with previous surgery and/or chemoirradiation. They may also be elderly and debilitated. The literature on reconstruction of the perineum can be confusing because knowledge has evolved by an accumulation of isolated short reports of individual methods. This led to the lack of a unifying basis for nomenclature and a failure to relate specific techniques to their roles in repairing particular types of defects. This article gives an overall summary of the approaches in a structured and rational manner. Defects of the external pelvis and perineal lining are usually amenable to coverage with local or regional fasciocutaneous flaps, if primary closure or skin graft is not appropriate. These flaps depend on the integrity of the vascular territories of the internal pudendal, the upper medial thigh plexus, or the descending branches of the inferior gluteal. The location and extent of the resection usually determine the requirements of the reconstruction and may dictate the choice of options. When defects are pelviperineal, particularly when the vagina needs to be reconstructed, myocutaneous flaps are of proven advantage in dealing with both the resurfacing as well as providing the bulk needed to fill the pelvic cavity after extensive resections. The rectus, gluteus, and gracilis are the best known options. Owing to the intrinsic limitations with the gracilis flap, the rectus and gluteus flaps have largely superseded its role in most situations. The rectus flap, in particular, provides good bulk as well as reliable skin. The use of muscle sparing flaps based on the perforator principle in suitable instances has increasingly been reported. The role of free tissue transfer, however, remains limited to isolated situations not amenable to current standard techniques. New and innovative reconstructive modifications keep appearing and larger scale series are needed for more evidence-based information on the outcomes achieved.

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Section: The Rectus Abdominismentioning

confidence: 99%

Reconstruction of the Perineum

Wong

2014

Annals of Plastic Surgery

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“…Les limites de ce lambeau sont : son volume musculaire faible, qui parfois nécessite l'utilisation bilatérale des muscles, et la faible surface cutanée utilisable. La viabilité de la partie distale de la palette cutanée est parfois douteuse, surtout chez les patients obèses avec des taux de nécroses de sa palette cutanée de 10 à 37 % [20,21]. De plus, la variabilité de position de son pédicule augmente la difficulté de la réalisation de ce lambeau : plus le pédicule est bas situé et plus son arc de rotation est limité le rendant parfois inutilisable.…”

Section: Lambeau De Muscle Gracilisunclassified

“…3) et de permettre une voie d'abord périnéale exclusive lorsqu'il n'y a pas de laparotomie. Cependant, la cicatrice de la face interne de cuisse est parfois inesthétique [20,21], et il peut exister des dysesthésies de la cuisse lors des rapports sexuels par compression exercée sur le pédicule nerveux [22].…”

Section: Lambeau De Muscle Gracilisunclassified

Techniques chirurgicales de traitement du carcinome épidermoïde de l’anus: amputation abdominopérinéale, colostomie périnéale, reconstruction périnéale par lambeaux

et al. 2011

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“…Neovaginal reconstruction combined with perineal repair, in patients undergoing radical surgery for urogenital cancer, has emerged as major indication for inferior pedicle based RAMF. Neovaginal reconstruction, after radical surgery for cancer, gives several advantages to the patients‐psychological benefits to the patient and her partner, decreased incidence of infection and small bowel complications 59. Post 1984 8, inferior pedicle based RAMF has replaced GMF as the first choice of vaginal reconstruction, due to propensity of GMF to partial/severe necrosis, prolapse and cosmetically unfavorable situation of donor site scar on the thigh.…”

Section: Vaginal Reconstruction With Ramf After Radical Surgery For Cmentioning

confidence: 99%

An evolution of clinical application of inferior pedicle based rectus abdominis myocutaneous flap for repair of perineal defects after radical surgery for cancer

Shukla

Tewari

2010

Journal of Surgical Oncology

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The inferior epigastric artery based rectus abdominis myocutaneous flap (RAMF) is one of the most versatile flaps used to bridge gaps in the perineum and groin, in the reconstruction of vagina after radical resections for cancer and in selected patients with benign and non-healing perineal lesions. Its use for reconstruction after Abdomino-perineal resection was first described in 1984. This review attempts to summarize the anatomic-technical aspects of inferiorly based RAMF and its applications.

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Neovaginal reconstruction with a rectus abdominis myocutaneous flap

Cited by 12 publications

References 0 publications

Reconstruction of the Perineum

Reconstruction of the Perineum

Techniques chirurgicales de traitement du carcinome épidermoïde de l’anus: amputation abdominopérinéale, colostomie périnéale, reconstruction périnéale par lambeaux

An evolution of clinical application of inferior pedicle based rectus abdominis myocutaneous flap for repair of perineal defects after radical surgery for cancer

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