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The journal «ONCOSURGERY» 2012, Vol.4, No 4

Using greater omentum as autoflap in mammoplasty in patients with breast cancer for nowadays

Pak DD, Troshenkov EA, Usov FN, Petrovskiy DA

PA Herzen Moscow Cancer Research Institute, Moscow, Russia
Contact: Troshenkov EA, e-mail:

Advantages and disadvantages of using greater omentum as autoflapt in patients with breast cancer are considered in the literature review.

Materials and methods: history of using greater omentum as a flap goes back more than 100 of years. The method of intake of the omentum flap open approach was offered first. The limitation of the aspect was affected by an additional scar on the anterior abdominal wall. In the late 90’s, due to the endoscopic surgery development, an opportunity of the omentum intake using laparoscopic technique appeared. A prerequisite for this was the detailed study of the features of vascular architectonics, innervation, and biochemical and microphysiologic features of the omentum. The literature covers a certain range of omentum intake methods, considering the tumor localization in different quadrants of the breast. Different options of vast omentum mobilization were determined, according to the vascularization variants and localization of connecting vascular branches. In general the preference is given to the omental flap vascularized by the right gasrto-omentalis arteries. The advantage of the omental flap is well vascularized tissue with sufficient volume to create a dome shaped breast. However, authors bring to notice the complication occurrence in 10% and more cases. Also the role of the omentum barrier cannot be underestimated. The duration and complexity of the operation, caused by abdominal stage, possibility of intraperitonial hemorrhage, possible abdominal adhesions are also mentioned by the authors. The using of free omental flap also requires microsurgical skills.

Conclusion. In general, easy mobilization, outstanding flexibility and good vascularization cause attractive perspective in using greater omentum to fill the volume of the breast after different variants of subcutaneous mastectomy. However, for the selection of this surgical technique is necessary to be aware of injury intervention on the abdominal cavity and possible complications connected with the removal of the important abdominal organ.

KEY WORDS: subcutaneous mastectomy, primary reconstructive surgery, breast cancer, greater omental flap, free greater omental flap.

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