Abstract
The combination of abdominal panniculectomy and hernia repair is becoming an increasingly accepted technique. Panniculectomy can be performed immediately in conjunction with hernia repair or on a delayed basis. Advantages of immediate panniculectomy include reduced infection, better healing, and improved patient satisfaction. Disadvantages include added length of the operation, compromised vascularity of the abdominal skin and fat, and the potential for delayed healing. There is a variety of approaches to performing a panniculectomy. These include a standard transverse panniculectomy, fleur-de-lis incision, and a Mercedes incision. A significant advancement in support of immediate panniculectomy is the concept of perforator sparing that can preserve the vascularity to the surrounding adipocutaneous tissues and facilitate body contouring and minimize morbidities related to delayed healing. Panniculectomy should be considered in patients with an abdominal hernia and pannus.
Keywords
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Cooper CM, Paige KT, Beshlian KM, Downey DL, Thrilby RC. Abdominal panniculectomies: high patient satisfaction despite significant complication rates. Ann Plast Surg. 2008;61:188–96.
Saulis AS, Dumanian GA. Periumbillical rectus abdominis perforator preservation significantly reduces superficial wound complications in “separation of parts” hernia repairs. Plast Reconstr Surg. 2002;109:2275.
Butler CE, Reis SM. Mercedes panniculectomy with simultaneous component separation ventral hernia repair. Plast Reconstr Surg. 2010;125:94.
Hughes KC, Weider L, Fischer J, et al. Ventral hernia repair with simultaneous panniculectomy. Am Surg. 1996;62:678–81.
Nahas FX, Ishida J, Gemperli R, et al. Abdominal wall closure after selective aponeurotic incision and undermining. Ann Plast Surg. 1998;41:606–17.
Netscher DT, Wigoda P, Spira M, et al. Musculoaponeurotic plication in abdominoplasty: how durable are its affects? Aesthetic Plast Surg. 1995;19:531–4.
Reid RR, Dumanian GA. Panniculectomy and the separation-of-parts hernia repair: a solution for the large infraumbilical hernia in the obese patient. Plast Reconstr Surg. 2005;116:1006.
Lockwood TE. Superficial fascial system (SFS) of the trunk and extremities: a new concept. Plast Reconstr Surg. 1991;86:1009–18.
Axer H, Keyserlingk DG, Prescher A. Collagen fibers in linea alba and rectus sheaths: I. General scheme and morphological aspects. J Surg Res. 2001;96:127–34.
Axer H, Keyserlingk DG, Prescher A. Collagen fibers in linea alba and rectus sheaths: II. General scheme and morphological aspects. J Surg Res. 2001;96:239–45.
Korenkov M, Beckers A, Koebke J, et al. Biomechanical and morphological types of the linea alba and its possible role in the pathogenesis of midline incisional hernia. Eur J Surg. 2001;167:909–14.
Rath AM, Attali P, Dumas JL, et al. The abdominal linea alba: an anatomic-radiologic and biomechanical study. Surg Radiol Anat. 1996;18:281–8.
Blondeel PN, Van Landuyt KH, Monstrey SJ, et al. The “Gent” consensus on perforator flap terminology: preliminary definitions. Plast Reconstr Surg. 2003;112(5):1378–83.
Houck JP, Rypins EB, Sarfeh IJ, Juler GL, Shimoda KJ. Repair of incisional hernia. Surg Gynecol Obstet. 1989;169(5):397–9.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Nahabedian, M.Y. (2013). Abdominoplasty and Panniculectomy in the Presence of Abdominal Wall Hernias. In: Latifi, R. (eds) Surgery of Complex Abdominal Wall Defects. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6354-2_15
Download citation
DOI: https://doi.org/10.1007/978-1-4614-6354-2_15
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-6353-5
Online ISBN: 978-1-4614-6354-2
eBook Packages: MedicineMedicine (R0)