ArticleJournal of plastic and reconstructive surgery2026
Endoscope-Assisted Deep Inferior Epigastric Perforator Flap for Breast Reconstruction: The First Reported Case in Japan.
Article in Journal of plastic and reconstructive surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
We report the first case of endoscope-assisted deep inferior epigastric perforator (E-DIEP) flap breast reconstruction in Japan. A 46-year-old woman underwent skin-sparing mastectomy with immediate reconstruction using a DIEP flap. Intramuscular perforator dissection was performed using an open approach, followed by pedicle harvesting using an endoscopic totally extraperitoneal technique. Consequently, a 14-cm pedicle was successfully obtained through a 3.5-cm fascial incision. Microsurgical anastomosis was performed via a mastectomy incision. Recovery was uneventful and the patient was discharged on postoperative day six without complications. This hybrid approach combines the advantages of minimal donor site morbidity and a long pedicle length, enabling tension-free anastomosis and safety. E-DIEP flap harvesting may serve as a practical and less-invasive alternative to robot-assisted techniques, particularly, in facilities where robotic systems are unavailable. This case demonstrated the feasibility and potential benefits of E-DIEP flap for clinical breast reconstruction.
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