Laparoscopic Total Extraperitoneal Deep Inferior Epigastric Perforator Flap Harvest: First Experience in the United Kingdom and Technical Guidance.

The deep inferior epigastric artery perforator (DIEP) flap is considered the gold standard for autologous breast reconstruction. Traditional DIEP flap harvest involves a large rectus sheath incision, which can lead to considerable abdominal morbidity, contributing to increased postoperative pain and prolonged length of inpatient stay. This has prompted the exploration of minimal access approaches. This short communication details our recent experience as the only unit in the United Kingdom to perform laparoscopic-assisted DIEP flap breast reconstruction, presenting a case series of 3 patients in the last 6 months. We perform this as a single-stage operation without delay, as has been described previously. Using this technique, we have been able to keep the fascial incision between 2 and 5.5 cm, compared with a length of 8-15 cm in the standard open approach. We demonstrate that this approach is technically feasible and safe, and we expect it will minimize long-term donor-site problems such as hernia and weakness.