LA RICOSTRUZIONE DELLA MAMMELLA MEDIANTE UTILIZZO DI MUSCOLO RETTO ADDOMINALE BIPEDUNCOLATO (SELETTIVO-SUPERSELETTIVO): CONSIDERAZIONI SPERIMENTALI

A musculocutaneous limbus of bipediculate rectus abdominis should be used in breast reconstruction, when the use of a monopediculate musculocutaneous limbus of rectus abdominis, particularly if a long and large limbus is needed, can be considered at risk. The bipediculate limbus of rectus abdominis increases the arterial flow and the venous drainage of the whole transposed abdominal island, but it implies a greater fragility of the abdominal wall, a more difficult surgical suture and lengthening of the surgical duration. Since 1991, in our Department, we have tried to obviate these difficulties by importantly reducing the muscular venter of the transposed muscle, and using several operative instrumental methods, such as high sensibility infrared (1/100 cc) and/or Tc99M isotype. A gamma-emitting tracer. Such methods have enabled the correct anatomicotopographic localization of each vascular pedunculus and hence the hyperselective isolation of myocutaneous limbs.