Endoscope-assisted rib cartilage harvesting.

The seventh and eighth costal cartilages were harvested through a small 1.5 to 2 cm skin incision made in the midinframammary fold in female patients and the inferior border of the seventh coastal cartilage in male patients using an endoscope (total, 5 patients). The lateral half of the costal cartilage is dissected subperichondrially under direct visualization through the access incision, and the residual half is dissected subperichondrially using an endoscope. The advantages of using an endoscope to harvest costal cartilage include a better remote access incision site and a reduced risk of perforations of the pleura and bleeding through endoscopically-magnified visualization. This technique is particularly useful when the patient is a woman.