الفهرس 
Breast anatomyOnly 14 pages are availabe for public view
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Abstract
The female breast is intimately associated with a woman’s self-esteem, sexuality, and interpersonal relations. Breast reconstruction following mastectomy affects directly the quality of life of the patient by restoration of the self-image and feeling complete again, and removal of the social stigma of having one or both breasts excised.
The development of diagnostic techniques and an increased awareness about breast cancer have made the early detection of breast cancer easier. This also resulted in the development of more and more conservative surgeries of breast cancer. Nowadays these conservative surgeries are developed to the degree of even conserving the skin covering the breast in what is called skin sparing mastectomy. With more development of surgical instrument, this skin sparing mastectomy can be performed endoscopically. This endoscopic approach minimizes post-surgical scarring to a small scar in a hidden site as axilla away from the breast.
All these developments in breast cancer surgeries increased the need for more advanced techniques for breast reconstruction. By using the same axillary incision and with the help of endoscope, breast reconstruction can be done either by harvesting latissimus dorsi muscle flap or by transaxillay breast implant application.
In transaxillary breast implant insertion with endoscopic approach, meticulous dissection can be done. This endoscopic approach can achieve better results than if done blindly.
One drawback of L.dorsi flap is the ugly unaccepted scar along the back. Using endoscopic assistance smaller scar, shorter hospital stay and more patient satisfaction can be achieved.
Other two techniques can be done with the help of endoscope and with minimal scars are omental flap harvesting and surgical delay of TRAM flap.
Omental flap is extremely malleable, adapts easily to irregular surfaces, and has a long and reliable vascular pedicle. Also the flap has a large absorption capacity, which reduces the postoperative time period during which drains are needed. The use of laparoscopy to harvest the flap offers minimal insult to the abdominal wall.
Delay of TRAM flap decreases the probability of necrosis. This delay can be by laparoscopic ligation of the deep and superficial inferior epigastric vessels intra or extra peritoneally. During this endoscopic procedure, the surgeon can also endoscopically visualize ovaries and the liver for metastasis.