关键词: 乳腺癌, 乳房重建, 腹壁下动脉穿支皮瓣, 腔镜外科

Abstract: The deep inferior epigastric artery perforator (DIEP) flap is the most commonly used procedure for autologous breast reconstruction. The classic technique for DIEP flap harvest requires a trans-Arcuate-line incision on the rectus sheath and may result in excessive traction on the intercostal nerves, leading to donor-site morbidity such as abdominal wall weakness, bulging, and even hernia. Therefore, it is essential to explore minimally invasive techniques for harvesting DIEP flaps. The laparoscopically assisted totally extraperitoneal (TEP) approach and the robot-assisted transabdominal preperitoneal (TAPP) approach are currently the two mainstream representative techniques for minimally invasive DIEP flap harvest. Given that the robotic-assisted technique is time- and money-consuming, and the TAPP approach poses risks of interference with the function of abdominal organs and damage to the peritoneum, the TEP technique for DIEP flap harvest is more suitable to be taken as a standard method. Deep understanding of the indications and technical highlights of the TEP technique is of great significance for spreading the concept and standardizing the application of minimally invasive DIEP flap harvest for breast reconstruction. It is expected to make a head-to-head comparison between laparoscopically assisted TEP-DIEP harvest and traditional DIEP maneuvers for breast reconstruction in the future.

Key words: breast cancer, breast reconstruction, deep inferior epigastric artery perforator flap, laparoscopic surgery