Expanding the Criteria for Robotic Deep Inferior Epigastric Perforator Flaps: Case Report With Long Intramuscular Course.

Abstract

Robotic harvest of the deep inferior epigastric perforator flap is gaining traction among plastic surgeons. However, its use is often limited to cases with short intramuscular length of the perforator (<4 cm) due to the need for a larger anterior fascial incision. We present a case of robotic-assisted transabdominal preperitoneal harvest of a 15-cm pedicle, including 9.1 cm intramuscular, through a 3.5-cm fascial incision. The patient had an uneventful intraoperative and postoperative course. Robotic deep inferior epigastric perforator harvest aims to reduce donor-site morbidity but has been limited to cases with a short intramuscular course. Using robotics instead of the open approach for intramuscular course dissection can expand its application by reducing the anterior rectus fascia incision.