Eur J Plast Surg (2013) 36:803–804 DOI 10.1007/s00238-013-0844-1 LETTER TO THE EDITOR An alternative approach for ilioinguinal lymphadenectomy in combination with a VRAM flap Alex Davies & Jennifer K O’Neill & Paul Wilson Received: 7 March 2013 /Accepted: 13 April 2013 /Published online: 3 May 2013 # Springer-Verlag Berlin Heidelberg 2013 Sir, After the malignant iliac lymph nodes had been cleared, In order to perform lymphadenectomy for high pelvic nodal the peritoneal sac was returned to the pelvis, and the disease, it is often necessary to perform division of the ingui- transversalis fascial/rectus abdominis defect was repaired nal ligament. An alternative approach is access via laparosco- with mesh, and the skin closed directly. py; however, this requires specialist expertise. Division of the The VRAM flap was inset into the femoral triangle inguinal ligament in these more extensive dissections is asso- providing both coverage of the femoral vessels and recon- ciated with a high risk of wound break down and herniae. We struction of the skin defect. present an alternative method of access to the pelvis by means For many patients, a superficial groin dissection remov- of elevating a vertical rectus abdominis myocutaneous ing lymph nodes within the femoral triangle
European Journal of Plastic Surgery – Springer Journals
Published: Dec 1, 2013
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