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Proposed Techniques in Abdominal Wall Transplantation
Jason Prigozen, MD
Risal Djohan, MD
Steven Bernard, MD
Maria Siemionow
Cleveland Clinic
2010-04-01
Presenter: Jason Prigozen
Affidavit:
Director Name:
Author Category: Resident/Fellow
Presentation Category: Clinical
Abstract Category: General Reconstruction
Composite tissue allotransplantation has become an accepted technique for certain reconstructive goals. A newer idea, that of abdominal wall as a composite tissue for transplantation, has entered the literature via transplant surgeons in the USA and Italy. Fifteen transplants have been performed worldwide, with only the 3 done in Italy involving microvascular surgery techniques. We are in preparation for our first patient to receive an abdominal wall transplantation concurrent with his small intestine transplantation. With this aim, the literature has been reviewed for technical aspects of the surgery. These, however, are lacking.
With this dilemma the microsurgical reconstruction team at our institution collaborated with the intestinal transplant surgeons to develop a technical plan for accomplishing procurement and transplantation of a composite abdominal wall flap based on microsurgical anastomotic techniques. Four fresh cadavers were dissected in order to develop the plan from an anatomical basis. Once this was accomplished the 2 teams joined together for logistical planning of the transplantation. With this accomplished, we then performed a "dry run" harvest in order to refine our ideas and timing.
We will present the relevant technical data, surgical planning and cadaveric dissections achieved in our pursuit.
