Relevance of intraoperative indocyanine green injection in breast reconstruction using DIEP procedure for abdominal scars

Abstract

Purpose of the study: The presence of midline sub-umbilical and/or suprapubic scar can sometimes hinder breast reconstruction using deep inferior epigastric perforator (DIEP) procedure.

Basic procedures: We report the use of indocyanine green injection in a 60-year-old woman in the context of deep inferior epigastric perforator (DIEP) procedure for unilateral breast reconstruction (bilateral breast cancer) with abdominal scar (midline sub-umbilical scar and Pfannenstiel incision scar).

Most important findings: This technique underlines the importance of neoangiogenesis mechanisms and helped simplify the surgical gesture initially planned (in order to ensure volume in spite of the scars as a DIEP procedure with double anastomoses was initially planned).

Principal conclusions: This intraoperative vascular imaging technique is a minimally invasive, simple and quick procedure allowing the precise visualization of vascularized territories.

Keywords: Abdominal scar; Breast reconstruction; Cicatrices abdominales; DIEP; DIEP flap; Indocyanine green; Microchirurgie; Microsurgery; Reconstruction mammaire; Vert d’indocyanine.