Lasso Vázquez, José MaríaSancho, M.Campo, V.Jiménez, ElenaPérez Cano, Rosa2026-02-062026-02-062007-04-21Lasso JM, Sancho M, Campo V, Jiménez E, Pérez Cano R. Epiperitoneal vessels: more resources to perform DIEP flaps. J Plast Reconstr Aesthet Surg. 2008 Jul;61(7):826-9. doi: 10.1016/j.bjps.2007.03.0041748-681510.1016/j.bjps.2007.03.004https://hdl.handle.net/20.500.14352/131623The development of the DIEP flap established an accepted concept of reconstructive surgery, but in patients who demonstrate inadequate in vivo flap perfusion, alternative surgical options to improve vascularisation are limited. We present a 42-year-old patient, with a left mastectomy whose breast was reconstructed with a DIEP flap. After anastomosis to the internal mammary vessels there was insufficient arterial perfusion of the flap. The situation was resolved by using an independent medial perforator artery emerging from the peritoneal layer (epiperitoneal vessels). This new pedicle was anastomosed end-to-end to the distal portion of the inferior epigastric artery. We consider that epiperitoneal vessels can be an emergency pedicle when needed and a possible alternative to the main pedicle of the DIEP flap. The development of the DIEP flap established an accepted concept of reconstructive surgery, but in patients who demonstrate inadequate in vivo flap perfusion, alternative surgical options to improve vascularisation are limited. We present a 42-year-old patient, with a left mastectomy whose breast was reconstructed with a DIEP flap. After anastomosis to the internal mammary vessels there was insufficient arterial perfusion of the flap. The situation was resolved by using an independent medial perforator artery emerging from the peritoneal layer (epiperitoneal vessels). This new pedicle was anastomosed end-to-end to the distal portion of the inferior epigastric artery. We consider that epiperitoneal vessels can be an emergency pedicle when needed and a possible alternative to the main pedicle of the DIEP flap.engjournal article1748-6815https://doi.org/10.1016/j.bjps.2007.03.00417446150https://www.sciencedirect.com/science/article/pii/S1748681507001799https://pubmed.ncbi.nlm.nih.gov/17446150/restricted access617DIEPEpiperitoneal vesselsMicrosurgeryBreast reconstructionCirugía32 Ciencias Médicas3213 Cirugía