Complete videoendoscopic harvest and transposition of latissimus dorsi muscle for the treatment of Poland syndrome: a first report.
ABSTRACT Poland syndrome is a rare congenital anomaly characterized by unilateral chest wall hypoplasia and ipsilateral hand abnormalities. The indications for chest and breast reconstruction are determined on the basis of functional and aesthetic concerns. The traditional open approach uses a latissimus dorsi muscle flap to attain chest symmetry. Endoscopically assisted latissimus dorsi muscle harvesting has been reported previously, combined with an additional incision for muscle fixation. We present a case series using minimally invasive surgery in Poland syndrome. In our last case, latissimus dorsi muscle harvesting and transposition was performed completely videoendoscopically. We believe we are the first to report this technique in the literature.
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ABSTRACT: Endoscopic techniques in plastic surgery have involved aesthetic procedures such as facelift, breast augmentation, abdominoplasty, and placement of tissue expanders. Recently, endoscopic harvest of the donor tissue for free flap transfer has included the omentum, jejunum, latissimus dorsi muscle, and rectus abdominis muscle. Ten patients with a soft-tissue defect in the lower extremity were successfully reconstructed from December 1994 to October 1995 with a free muscle transfer after endoscopic harvest of the latissimus dorsi muscle. Nine patients were male and 1 patient was female. A 5- to 6-cm incision was initially made along the posterior axillary line, allowing direct identification of the thoracodorsal vascular pedicle. The latissimus dorsi muscle was dissected posteriorly until the limits of open dissection were reached, and then the dissection was continued under endoscopic visualization. The largest harvested muscle was 15 x 25 cm in size. Follow-up ranged from 6 to 15 months. We believe that plastic surgeons can take advantage of endoscopic techniques to obtain reliable and safe results, with smaller scars and reduced postoperative donor site morbidity such as pain and wound-healing problems. This technique may prove particularly applicable to women, children, and patients who are prone to hypertrophic scars.Annals of Plastic Surgery 07/1997; 38(6):586-93. · 1.38 Impact Factor
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ABSTRACT: We describe a 22-year-old man with Poland's syndrome and two other rare deformities which, to our knowledge have not been reported previously. The first deformity was a fibrotic band between the nipple-areola complex and the medial epicondyle of the humerus, and the second was a fifth digit with two phalanges. A single midaxillary vertical incision was used to harvest and then transfer the latissimus muscle for soft tissue reconstruction of the chest wall deformity. Almost complete symmetry was achieved and the scar was well hidden by the arm. The aesthetic and functional results were satisfactory.Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery 02/2003; 37(5):304-6. · 0.94 Impact Factor
Article: Poland's syndrome revisited.[show abstract] [hide abstract]
ABSTRACT: Poland's syndrome is a rare congenital anomaly characterized by unilateral chest wall hypoplasia and ipsilateral hand abnormalities. Literary data suggest its sporadic nature. The prevailing theory of its cause is hypoplasia of the subclavian artery or its branches, which may lead to a range of developmental changes. The incidence of Poland's syndrome varies between groups (male versus female patients, congenital versus familial cases, and so on) and ranges from 1 in 7,000 to 1 in 100,000 live births. Cases of Poland's syndrome associated with leukemia, carcinoma of the hypoplastic breast, and other conditions, confirm the relationship between developmental defects and tumors, and require oncologic awareness. Various manifestations, age, and gender require different surgical approaches. Our experience, which includes 27 patients (15 male, 12 female), 20 of whom (12 male, 8 female) underwent operation, suggests that the repair should be done in two stages in children and in a single stage in adults. Reconstruction and/or stabilization of the aplastic ribs may be achieved using bone grafts or prosthetic mesh. Muscle flaps and breast implants may be used to correct muscle deficiency and breast hypoplasia and to help achieve a complete cosmetic repair.The Annals of Thoracic Surgery 01/2003; 74(6):2218-25. · 3.45 Impact Factor