Breast reconstruction 'pushes envelope'

An Australian-first procedure is producing better outcomes for women requiring breast reconstruction after cancer removal.

Surgeons at Sydney's Westmead Private Hospital delivered the breakthrough technique, which uses healthy tissue from the patient's lower abdomen following their mastectomy.

Assisted by laparoscopic instruments, the team performed a complex procedure - known as a DIEP Flap Harvest - to take skin, fat and blood vessels and reattach them to the chest using microsurgery.

"This is a team effort, where we brainstormed the idea, looked at journal articles from overseas and came up with a plan where everyone knew their role and were able to execute it," said Dr Bish Soliman, who was joined by fellow plastic surgeon Dr Varun Harish, breast surgeons Associate Professor James French and Dr Negin Sedaghat, and general surgeon Dr Lawrence Yuen.

"It was exciting to push the envelope and evolve whilst putting patient safety first," Dr Soliman added. "Improving surgical interventions is key to improving surgical outcomes."

He said the laparoscopic instruments allowed the surgeons to minimise fascial incisions and consequent denervation of the abdominal wall.

"Autologous breast reconstruction has markedly evolved since the transverse rectus abdominis muscle flap initially described in 1982," Dr Soliman said.

"The reported advantages of a laparoscopic-assisted approach include minimising the fascial incision length and reducing both the incidence of nerve damage and the dissection process which may result in a weakened abdominal wall.

"It is hypothesised that this results in a quicker recovery, less pain and reduced donor-site morbidity."

The first patient at Westmead Private Hospital to have the surgery was Cathy Watton, who had been diagnosed with breast cancer in July 2021.

"When I was asked about being the first patient for this new procedure, I was unsure but also quite proud," the 51-year-old said.

"Dr Soliman explained the difference between his current method and the procedure he was going to do on me. If I was to be honest, I was very nervous but I put my trust in him and his team.

"Today I feel great, I was never going to let breast cancer rule me."

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