Intra-abdominal organs are very useful for a variety of reconstructions. However, there are many pitfalls inherent in their transfer because of anatomical variations and their sensitivity to ischemia time. With the advancement of plastic surgery the difficulties have been overcome step by step, and we have achieved advanced reconstructions in many fields, which were impossible with conventional methods. The most important topics will be presented:
(1)Voice reconstruction with a voice prosthesis can achieve a fair result; however, this type of reconstruction has many drawbacks. Another direction in voice reconstruction has been the development of methods to restore voice using seqments of bowel. In this type of reconstruction, autogenous tissue, particularly bowel is used to reconstruct a voice tube. Even though microsurgical transfer of bowel for reconstructing the esophagus have become fairly routine, the use of these same methods for voice reconstruction poses a unique set of obstacles that are currently being overcome. Autogenous tissue such as jejunum, ileocolon, and appendix have all been applied to create voice tubes at the same time as esophageal reconstruction or as a seqarate procedure. Among these methods, jejunum and ileum are the most commonly used. Simultaneous reconstruction of the esophagus and voice tube using bowel segments has the following advantages: lack of complications that might be associated with the long-term use of voice prostheses. At present, we prefer the use of an ileocolon flap for the reconstruction of both the esophagus and voice tube in one setting. Although laryngeal allo-transplantation has potential applications, its use will be limited. Future trends in voice reconstruction might use a combination of both autogenous tissue and tissue engineered constructs to produce high-quality voice with little to no side effects.
(2) Other intra-abdominal organs can be used for various reconstructions, such as diversion loop for cases of epiglottis injury, appendix for reconstruction of urethra, jejunum for reconstruction of vagina, colon and appendix for reconstruction of vagina and cervix, vascularized lymphatic cable for chymoperitoneum, etc. Examples will be provided for each category described above.