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Successful Laparoscopic Harvesting of Omental Pedicle Flap for Salvage Cerebral Revascularization in 2 Adults With Moyamoya Disease: Technique and Lessons Learned
- Source :
- Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 27:e111-e115
- Publication Year :
- 2017
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2017.
-
Abstract
- Moyamoya is an idiopathic and progressive disease that leads to occlusion of intracranial arteries. When other methods of revascularization fail, omentum can be used as an indirect bypass to improve cerebral perfusion. Laparoscopic mobilization of a pedicled omental flap with subcutaneous tunneling to the brain has been described in small case series in children. We report our techniques and outcomes in 2 adults with Moyamoya to undergo such a procedure. An omental flap based on the right gastroepiploic artery was created and intraoperative fluorescence imaging using indocyanine green was used to assess the viability of the flap and to guide lengthening of the pedicle. The flap was tunneled subcutaneously using skip incisions. There were no intraoperative complications and no postoperative complications related to the omental flap. Follow-up evaluation demonstrates viable omental flaps and improved cerebral vascularization. This technique is feasible in adults who require salvage cerebral revascularization for Moyamoya disease.
- Subjects :
- Indocyanine Green
medicine.medical_specialty
medicine.medical_treatment
Cerebral Revascularization
Revascularization
Transplant Donor Site
Right gastroepiploic artery
Surgical Flaps
Young Adult
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
medicine.artery
Occlusion
Humans
Medicine
Moyamoya disease
Cerebral perfusion pressure
Salvage Therapy
business.industry
Graft Survival
Optical Imaging
Middle Aged
medicine.disease
Surgery
Treatment Outcome
chemistry
030220 oncology & carcinogenesis
Tissue and Organ Harvesting
Feasibility Studies
Laparoscopy
Radiology
Moyamoya Disease
business
Omentum
Indocyanine green
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15304515
- Volume :
- 27
- Database :
- OpenAIRE
- Journal :
- Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
- Accession number :
- edsair.doi.dedup.....626f2bee982592c9fb33d383acd0a3f4
- Full Text :
- https://doi.org/10.1097/sle.0000000000000448