J Neurol Surg B Skull Base 2015; 76(01): 025-028
DOI: 10.1055/s-0034-1368147
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Scarless Abdominal Fat Graft Harvest for Neurosurgical Procedures: Technical Note

Victoria T. Trinh
1   Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, United States
,
Edward A. M. Duckworth
1   Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, United States
› Author Affiliations
Further Information

Publication History

20 August 2013

23 November 2013

Publication Date:
02 September 2014 (online)

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.

 
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