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Intraoperative Navigation-Assisted Identification of Deep Inferior Epigastric Artery Perforators
Frederick Durden, M.D., Katherine Carruthers, Oriana Haran, M.D., Ergun Kocak, M.D., M.S.
The Ohio State University
2012-01-28
Presenter: Ergun Kocak, M.D., M.S.
Affidavit:
N/A
Director Name: Michael Miller, M.D.
Author Category: Attending
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
How does this presentation meet the established conference educational objectives?
This presentation meets the criteria of Objective 3 of the conference. I will discuss a new technique for the identification of perforating vessels during autologous breast reconstructions.
How will your presentation be used by practicing physicians in the audience?
This study has shown that an armless navigation system can be used in conjunction with a modified bovie to facilitate the intraoperative identification of perforators during autologous breast reconstructions. This technique could allow surgeons to more quickly and accurately elevate flaps for these types of procedures.
The Deep Inferior Epigastric Perforator Flap is a common operation for autologous breast reconstruction. Imaging of perforators, through the use of computed tomographic angiography (CTA), is used as a preoperative tool to identify the perforators. Currently, methods of translating the location of perforators seen on these preoperative images to the actual patient anatomy are limited. Armless navigation systems, commonly used in neurosurgical procedures, can be used to correlate imaging to operative anatomy, but they are generally thought to rely on relatively rigid structures which have minimal deformation during surgical intervention. We have developed a novel method for using the navigation system to provide real-time, intraoperative tracking of a modified bovie handle to facilitate identification of perforating vessels at the level of the anterior abdominal fascia. Future studies will determine if this navigation system could also be used to intraoperatively verify the preoperative CTA findings.
