Endoscopic-assisted flap harvesting. Endoscopic-assisted procedures are widely performed because of the minimum scarring involved. However, there are a limited number of reports regarding the harvesting of flaps with the assistance of endoscopes. We have described our clinical experience of endoscopic-assisted flap harvesting. Data concerning flaps and operation times, drainage amounts, complications, etc., were retrospectively recorded. From 1996 to 2003, endoscopic-assisted flap harvesting was performed on 30 patients. The harvested flaps were as follows: omental flaps in 9 cases, the latissimus dorsi muscles in 9, fascias lata in 6, jejunal segments in 5 and the rectus abdominis muscle in 1. Mean follow-up was 18 months. Mean flap harvesting time was recorded as 90 minutes in muscle flaps, 40 in fascia lata, 90 (30; intra-abdominal marking using endoscope, 60; harvesting in minilaparotomy) in omental flaps and jejunal segments. Minor complications included 3 patients who showed incomplete cervical neuroparalysis, transient sensory disturbance of the femur, and dehiscence of the umbilical area. No abdominal complications or scar revisions were observed in this series. Endoscopic-assisted flap harvesting should be considered as a useful, minimally invasive procedure for donor sites, despite the longer operation times.