Reconstruction of the chest wall and the diaphragm using the inverted Y Marlex methylmethacrylate sandwich flap

Abstract

This is an easy and safe technique resulting in a stable and satisfactory reconstruction after large antero-lateral full-thickness chest wall resections involving the diaphragm.

Tumors of the Diaphragm

“…Options for reconstruction include various prosthetic materials suitable for diaphragm reconstruction. 63 Also, some literature supports the use of tissue flaps, particularly when there is concern for leaving behind a foreign material with risk of infection/erosion. Some of the flaps that have been described include transversus abdominus/internal oblique muscle, external oblique muscle, latissimus dorsi muscle, and omentum.…”

Sternum Resection and Chest Wall Reconstruction with Metaacrilate Implant in Tuberculosis

“…In cases of the sternal, chest wall, and diaphragm reconstruction, Composix Mesh™, titanium mesh, and Marlex mesh [6] as well as methyl methacrylate [7,8] were also successfully used. Although resection of tumors in this region with sufficient margins may lead to large chest wall defects, primary closure of these defects can be satisfactorily achieved in most cases.…”

Chest wall and diaphragm reconstruction; a technique not well established in literature

“…Not many reports are found discussing diaphragm reconstruction combined with chest wall reconstruction for chest wall tumors. Diaphragm is pulled to the original position and after resection is proposed by Sugarbaker and colleagues [3] using a synthetic mesh; where the patch is anchored in place by suturing it to the surrounding structures, following the natural course of the diaphragm with care taken to stretch the patch and place the sutures under some tension to avoid billowing of the patch [3,5,7] . Some studies discuss the use of fasia lata graft [4] and latissimus dorsi ap for diaphragmatic reconstruction [6,8] .…”