Massive panniculectomy and hernioplasty as a salvage procedure

Summary

Background

Salvage panniculectomy is sometimes the only solution to remove a massive pannus or abdominal apron, which is the source of many physical, social, and emotional problems for the patient. Often, the panniculus morbidus prevents weight loss, as the patient cannot exercise and can lead to hygiene and chronic pain issues, including intertrigo, chronic infections, ulcerations, and low-back pains. The heavier the panniculus, the more marked the symptoms.

Case report

Here, we present a case of a severely obese patient, with a large panniculus extending below the knees, accompanied by a large abdominal incisional hernia containing intestines. Recently, the patient’s lower abdomen became ischemic and infected, making the patient’s diabetes mellitus difficult to control. After a long ineffective period of local care and antibiotic therapy, the surgical removal was attempted. Surgery consisted resection of a 16-kg panniculus and incisional hernia repair with a resorbable mesh.

Results

Postoperative recovery was relatively simple. Patient’s quality of life showed a dramatic improvement, as well as the hygiene, toilet habits, and mobility.

Conclusion

In this kind of patients, surgery can be technically difficult and carries significant postoperative risks, but it remains the only viable option for long-term survival.