Road Map to Success for DIEP Flap Surgery: Fluorescence Imaging
A Patient’s Story
Would you take a road trip before consulting a map, planning out your best route with the least amount of obstacles to drive around or through? Think of the SPY Elite Fluorescence Imaging System in this way for breast reconstruction surgery. DIEP flap breast reconstruction surgery is a specialized and intricate process that women have the option of choosing to rebuild their breasts after a mastectomy. It is what I chose after a second breast cancer diagnosis.
Patients are savvy, engaged, customers these days with the internet and social media to guide them in learning about the surgical procedures that they are facing. DIEP flap surgery is intricate, long and must be done by a well-qualified microsurgeon. Choosing this profession is a passion for a majority of physicians because they are transforming lives after breast cancer. It takes years of additional medical training and intense hours in the operating room to achieve optimal patient outcomes.
Passion and skill for the profession is one piece of the equation for a successful surgery. Vital to the success of the procedure are the tools that these skilled surgeons use while performing DIEP flap. As a patient, I was interested in knowing the details of the surgery. Knowing that my reconstructive surgeon used the SPY Elite during my procedure gave me peace of mind. Why?
DIEP flap surgery involves disconnecting a blood source from one part of the body, the tummy area, and transferring it to the breast area to create a new, warm, soft, breast mound that is entirely the patient’s own tissue. Finding the origin of the viable blood flow, in this case the deep inferior epigastric perforator (DIEP) is the key to successful DIEP flap surgery. Knowing it is a viable blood source before disconnecting and reattaching it to the new source is available in real-time during surgery using fluorescence imaging. This gives the surgeon performing the procedure the tools needed to plan and successfully execute this complex surgery.
How does it work? Anatomies vary on the inside just as they do on the outside. When the patient is asleep, a fluorescent medium is injected into the veins through an IV. As it travels through the body, a camera is placed over the patient so that the microsurgeon can assess viable blood flow in real-time. This provides the surgeon immediate feedback and the ability to make decisions based on the images seen via the SPY Elite. The ability to make a decision in real-time and even multiple times during this lengthy surgery results in far better patient outcomes.
This is known as intraoperative perfusion assessment. Think of it in this way- the microsurgeon is working with small blood vessels. SPY imaging allows the surgeon to find the blood vessels, assess their viability before disconnecting them, and evaluate the blood flow after reconnecting them to the breast area and then monitoring the flow after the flaps are in place. Blood vessels, because of their structure, have the potential of twisting or kinking. The use of SPY Elite during DIEP flap surgery allows the surgeon to view the perfusion and proper flow of the blood vessels each step of the way and make adjustments if needed during the surgery.
Peace of mind for patients? Absolutely! I have spoken to many women about their DIEP flap procedures. It takes a great deal of mental fortitude, research, planning and careful decision making to move forward with this unique and complicated surgery but when it all falls into place the results can be life changing. Patients are at an advantage and have greater peace of mind when they know there is proven scientific technology that is critical to the success of this surgery.
My advice to women considering DIEP flap breast reconstruction, or for that matter, any type of breast reconstruction, ask your microsurgeon if he or she uses NOVADAQ’s SPY Elite in the OR. It was developed to improve outcomes and reduce complications and studies have shown that it does. I am happy to report that my DIEP flap breast reconstruction resulted in excellent outcomes with no complications. SPY Elite imaging was part of the process and gave me peace of mind knowing that should complications arise during surgery, tools were in place to address the problem and make the necessary corrections.
