Endoscopic subcutaneous neurovascular lower-extremity myofascial flap harvesting for genitourinary reconstruction

Karen E. Boyle, Michael E. Moran, Christopher J. Calvano, Mark D. White, Pramod P. Reddy, Bryan A. Mehlhaff

Research output: Contribution to journalArticle

Abstract

Neurovascular myofascial flaps have been widely utilized when healthy tissues outside the anatomic confines of the pelvis are necessary for complex genitourinary reconstructions. Myofascial flaps have great potential in providing support and tone to the bladder neck in a model of total urinary incontinence. Two muscles were evaluated for minimally invasive harvesting utilizing an adult rabbit and human cadaveric model: the gracilis, because of its neurovascular supply and length, and the sartorius, because of its location. Three adult New Zealand White rabbits were prepared and draped in sterile fashion after general anesthesia. Bilateral 2-cm incisions were made over the origins of the gracilis and sartorius muscles. Dissection times were entered in a database on a personal computer for paired Student t-tests. Special techniques for dissection included utilization of a 5-mm subcutaneous dissector/retractor and reticulated scissors and dissector. Once the tissues were harvested, rotational angles of the functional arcs around the origins of the gracilis and sartorius flaps were measured, as were the lengths of the muscular flaps from the proximal pedicle to the free distal end. Initial positioning of the myofascial flap at the bladder neck was investigated in this nonsurvival study. Blood loss was estimated before the animals were humanely sacrificed. The possibilities of minimally invasive genitourinary reconstruction are numerous. Both flaps can be dissected endoscopically and have rotational angles allowing transfer to more cephalad positions in the groin or intra-abdominally. Further studies are needed to establish the efficacy of the myofascial graft for minimally invasive genitourinary reconstructions.

Original languageEnglish (US)
Pages (from-to)187-191
Number of pages5
JournalJournal of Endourology
Volume12
Issue number2
StatePublished - Apr 1998
Externally publishedYes

Fingerprint

Dissection
Lower Extremity
Urinary Bladder
Rabbits
Groin
Microcomputers
Urinary Incontinence
Pelvis
General Anesthesia
Databases
Students
Transplants
Muscles
Gracilis Muscle

ASJC Scopus subject areas

  • Urology

Cite this

Boyle, K. E., Moran, M. E., Calvano, C. J., White, M. D., Reddy, P. P., & Mehlhaff, B. A. (1998). Endoscopic subcutaneous neurovascular lower-extremity myofascial flap harvesting for genitourinary reconstruction. Journal of Endourology, 12(2), 187-191.

Endoscopic subcutaneous neurovascular lower-extremity myofascial flap harvesting for genitourinary reconstruction. / Boyle, Karen E.; Moran, Michael E.; Calvano, Christopher J.; White, Mark D.; Reddy, Pramod P.; Mehlhaff, Bryan A.

In: Journal of Endourology, Vol. 12, No. 2, 04.1998, p. 187-191.

Research output: Contribution to journalArticle

Boyle, KE, Moran, ME, Calvano, CJ, White, MD, Reddy, PP & Mehlhaff, BA 1998, 'Endoscopic subcutaneous neurovascular lower-extremity myofascial flap harvesting for genitourinary reconstruction', Journal of Endourology, vol. 12, no. 2, pp. 187-191.
Boyle KE, Moran ME, Calvano CJ, White MD, Reddy PP, Mehlhaff BA. Endoscopic subcutaneous neurovascular lower-extremity myofascial flap harvesting for genitourinary reconstruction. Journal of Endourology. 1998 Apr;12(2):187-191.
Boyle, Karen E. ; Moran, Michael E. ; Calvano, Christopher J. ; White, Mark D. ; Reddy, Pramod P. ; Mehlhaff, Bryan A. / Endoscopic subcutaneous neurovascular lower-extremity myofascial flap harvesting for genitourinary reconstruction. In: Journal of Endourology. 1998 ; Vol. 12, No. 2. pp. 187-191.
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