ObjectiveTo explore the methods of breast reconstruction surgery with laparoscopically harvested pedicled omental flap (LHPOF), and analyze the patient’ evaluation, operation process and postoperative follow-up. MethodsPatients with pathologically proven breast cancer or plasma cell mastitis who underwent LHPOF breast reconstructive surgery were retrospectively collected from the Department of Breast and Thyroid Surgery of The Second Affiliated Hospital of Chongqing Medical University from February 2022 to December 2023. ResultsA total of 16 patients were collected. The mean age of patients was 43.3 (ranging from 27 to 68) years old, the mean body mass index of patients was 23.0 kg/m2 (ranging from 18.3 to 28.6 kg/m2). One patient underwent transplant omental flat removal surgery due to postoperative flap thrombosis, and one patient choose to give up breast reconstruction due to insufficient flap volume. The single-stage surgery was performed successfully in the rest patients with no requirement of laparotomy. All patients made an uneventful recovery after surgery. During the follow-up period, which averaged 13 months and ranged from 9 to 17 months, the major symptoms were mild epigastric bulge (2 patients) and flap atrophy (1 patient), no serious flap-related or donor site-related complications such as flap loss, bowel dysfunction and abdominal incisional hernia. In general, the aesthetic results were satisfactory. ConclusionsUsing LHPOF in immediate breast reconstruction surgery can achieve satisfied aesthetic result, for the soft and natural appearance of the reconstructed breast. In the mean time, compared with other autologous tissue reconstruction approaches, LHPOF has lower incidences of complications of donor-site and flap-site.