**2. Latissimus Dorsi myo-cutaneous flap**

*Introduction:* Latissimus Dorsi or LD myocutenous flap was initially described by Ignio Tansini in 1906 [1]. Being a regional flap with a reliable blood supply makes it a good option for breast reconstruction especially for women with small size breasts. However, it is often used along with implants or prostheses so it is not preferred as a first choice by many surgeons.

## **2.1 Relevant anatomy**

Latissimus Dorsi is the largest, fan-shaped, flat muscle situated on the back on both sides which *arises from* the lower 6th ribs, spinous process of 6th or 7th thoracic vertebrae to 5th lumbar vertebrae, from sacrum, posterior iliac crest, and thoracolumbar fascia, and gets *inserted at* the bicipital groove of the humerus. It is *supplied by* the thoracodorsal artery and vein which is a branch of the subscapular artery and vein respectively and *innervated by* the thoracodorsal nerve. It also has several minor pedicles, that arise from perforators of the intercostal artery, thus making it the *type V muscle* type of Mathes and Nahai. The main *function* of the LD muscle is extension, adduction, and internal rotation of the arm.
