Scarless Abdominal Fat Graft Harvest for Neurosurgical Procedures: Technical Note

• Published in: Journal of neurological surgery. Part B, Skull base Vol. 76; no. 1; pp. 025 - 028
• Main Authors: Trinh, Victoria T., Duckworth, Edward A. M.
• Format: Journal Article
• Language: English
• Published: Stuttgart · New York Georg Thieme Verlag KG 01.02.2015
• Subjects: Original Article; abdominal fat graft harvest; scarless neurosurgery; minimal access; skull base reconstruction
• ISSN: 2193-6331; 2193-634X
• DOI: 10.1055/s-0034-1368147

Abstract Background  Abdominal fat grafts are often harvested for use in skull base reconstruction and cerebrospinal fluid (CSF) leak repairs, and for operations traversing the nasal sinuses or mastoid bone. Although the endoscopic transnasal surgery has gained significant popularity, in part because it is considered “scarless,” a common adjunct, the abdominal fat graft, can result in a disfiguring scar across the abdomen. Objective  This is the first report of a scarless abdominal fat graft technique for skull base reconstruction. Methods  Ten patients with a median age of 56.5 years (range: 45–73 years) underwent endoscopic transsphenoidal tumor resection with intraumbilical fat graft harvest. Careful circumferential fat dissection at the umbilicus, with progressive retraction of the graft, was crucial to ensure maximal visualization and to prevent injury to the subcutaneous vessels and rectus fascia. Results  Following reconstruction of the sellar skull base, all patients did well postoperatively with no evidence of CSF leak. At 12-week follow-up for all patients, there was no evidence of scar, intracavity hematoma, or wound infection. Conclusions  Fat graft harvest through an intraumbilical incision results in a scar-free abdominal harvest, and is a useful procedural adjunct to complement “scarless” brain surgery.