The role of cinematic rendering in pre-operative planning of a thoracodorsal artery perforator flap (TDAP) phalloplasty: a case study

The thoracodorsal artery perforator (TDAP) flap is a muscle-sparing skin and fat flap that requires precise intramuscular dissection of the thoracodorsal artery perforators in the axillary region. Pre-operative image-based treatment planning is a crucial part of flap design. In this article, we discuss the first-ever reported use of the cinematic volume rendering technique (CVRT) to evaluate the thoracodorsal artery for a TDAP flap phalloplasty in a 49-year-old transgender patient. Cinematic volume rendering technique uses light maps to generate photo-realistic three-dimensional images of the thoracodorsal artery and its perforators. These images aid the surgeon in evaluating optimal perforators and latissimus dorsi muscle involvement for more efficient flap design.