Endoscopic-assisted Versus Open Latissimus Dorsi Flap Harvest for Breast Reconstruction: A Randomized Comparative Study.
- 1From the Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
Abstract
Background
The latissimus dorsi (LD) flap remains a reliable option for breast reconstruction; however, the long donor-site scar represents a major concern. Endoscopic-assisted LD flap harvest has been introduced to improve cosmetic outcomes while maintaining reconstructive efficacy. The current study evaluates endoscopic-assisted LD flap harvest for breast reconstruction and compares it with the open technique regarding donor-site morbidity, cosmetic outcome, patient satisfaction, and operative variables.Methods
A prospective randomized controlled trial was conducted at Kasr Al Ainy Hospital between January 2023 and July 2025. Fifty-nine female patients (60 flaps) seeking breast reconstruction (without skin deficiency or requiring a skin island ≤6 cm in the longest dimension) were included. Patients were randomly assigned to undergo an endoscopic-assisted (group A) or open (group B) LD flap harvest. Ethical approval was obtained from Cairo University (approval no.: MD-242-2023).Results
Group A demonstrated significantly higher donor-site satisfaction with shorter scars (5.87 versus 19.45 cm, P < 0.001), but required longer operative time (3.42 versus 1.72 h, P < 0.001). Breast satisfaction scores and complication rates were comparable between groups. Hospital stay and recovery were slightly shorter in group A.Conclusions
Endoscopic-assisted LD flap harvest is a safe and effective technique offering superior aesthetic results with reduced scarring. Although associated with an advanced learning curve and longer operative time, careful patient selection and personalized treatment planning can optimize results.
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BibTeX
@article{fayek2026endoscopicassisted,
title = {{Endoscopic-assisted Versus Open Latissimus Dorsi Flap Harvest for Breast Reconstruction: A Randomized Comparative Study.}},
author = {Mina Fayek and Yomna Salah and Laila A Aboul Nasr and Ayman Noaman and Adel M Wilson},
journal = {Plastic and reconstructive surgery. Global open},
year = {2026},
month = oct,
doi = {10.1097/gox.0000000000008210},
url = {https://europepmc.org/article/MED/42921360},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Endoscopic-assisted Versus Open Latissimus Dorsi Flap Harvest for Breast Reconstruction: A Randomized Comparative Study.
AU - Mina Fayek
AU - Yomna Salah
AU - Laila A Aboul Nasr
AU - Ayman Noaman
AU - Adel M Wilson
PY - 2026
DA - 2026/10/23
JO - Plastic and reconstructive surgery. Global open
DO - 10.1097/gox.0000000000008210
UR - https://europepmc.org/article/MED/42921360
AB - Background The latissimus dorsi (LD) flap remains a reliable option for breast reconstruction; however, the long donor-site scar represents a major concern. Endoscopic-assisted LD flap harvest has been introduced to improve cosmetic outcomes while maintaining reconstructive efficacy. The current study evaluates endoscopic-assisted LD flap harvest for breast reconstruction and compares it with the open technique regarding donor-site morbidity, cosmetic outcome, patient satisfaction, and operative variables.Methods A prospective randomized controlled trial was conducted at Kasr Al Ainy Hospital between January 2023 and July 2025. Fifty-nine female patients (60 flaps) seeking breast reconstruction (without skin deficiency or requiring a skin island ≤6 cm in the longest dimension) were included. Patients were randomly assigned to undergo an endoscopic-assisted (group A) or open (group B) LD flap harvest. Ethical approval was obtained from Cairo University (approval no.: MD-242-2023).Results Group A demonstrated significantly higher donor-site satisfaction with shorter scars (5.87 versus 19.45 cm, P < 0.001), but required longer operative time (3.42 versus 1.72 h, P < 0.001). Breast satisfaction scores and complication rates were comparable between groups. Hospital stay and recovery were slightly shorter in group A.Conclusions Endoscopic-assisted LD flap harvest is a safe and effective technique offering superior aesthetic results with reduced scarring. Although associated with an advanced learning curve and longer operative time, careful patient selection and personalized treatment planning can optimize results.
SN - 2169-7574
ER -