PRMA Using Latest Technology in Breast Reconstruction

by Wendy Rigby - KENS 5 News


San Antonio's PRMA is one of only a handful of facilities in the country offering the latest technology in breast reconstruction surgery — a system that gives surgeons a more precise way to evaluate blood flow within the tissues they are operating on.

Plastic surgeon, Dr. Minas Chrysopoulo is a man on a mission. He wants more breast cancer patients to know that when they face a mastectomy, they can have their breast reconstructed at the same time. Dr. Chrysopoulo and his partners use this latest technology routinely when reconstructing breast cancer patients.

The most common reconstructive breast procedure performed at PRMA is a very specialized and complex surgery called the "DIEP flap", where the surgeons take skin and fat from the patient's abdomen, and use it to form a natural-looking breast. By using Novadaq's new imaging system called "SPY", the doctor is able to choose the best blood supply for the skin and fat that will form the new breast, while preserving all the stomach muscles. The key is a special dye — a fluorescent agent injected into the body during the four hour operation.

"It's a bit like an angiogram but without exposing the patient to radiation," said Dr. Chrysopoulo. "The dye travels through the bloodstream and basically lights up the blood vessels. It provides a bit of a road map for us, and it sometimes helps us identify the most important vessels a little bit quicker. It helps us formulate the best surgical plan so that we can preserve the patient's abdominal muscle. Unlike alternative imaging techniques like CT angiograms (CTA), the SPY also avoids exposing the patient to radiation."

Dr Chrysopoulo says he also uses the SPY to check blood flow to the tissues left behind by the mastectomy - "More and more patients are now undergoing skin-sparing and even nipple-sparing mastectomies in conjunction with immediate reconstruction. The SPY allows us to ensure that the tissues preserved by the mastectomy have a healthy blood supply and can be used as part of the reconstruction."

Dr. Chrysopoulo and his partners have used the SPY system on hundreds of DIEP flap patients with great success. After time, the resulting breast is natural looking and natural feeling.

While the abdomen is scarred like after a tummy tuck procedure, the abdominal muscles and core strength are preserved. This tedious microsurgery is on the cutting edge of breast reconstruction. Doctors say waking up from cancer surgery with a new breast can make a big difference on a woman's outlook.

"Psycho-socially, it's a huge deal to wake up without a flat chest," Dr. Chrysopoulo said.

Only about 40 plastic surgeons in the country perform the DIEP procedure routinely and not all use the SPY. Patients come to San Antonio from all over the United States and even from some foreign countries to have the operation that promises less pain, a shorter hospital stay and a faster recovery.

Learn more about DIEP flap surgery here.