The partial underlay preperitoneal with panniculectomy repair for incisional abdominal hernia in the morbidly obese.
Publication/Presentation Date
1-1-2014
Abstract
BACKGROUND: Because of high frequency, high morbidity, and difficulty of repair, incisional hernias in obese patients represent a particularly vexing and common problem for surgeons. The objective of this study was to describe a highly selective technique for incisional hernia repair with panniculectomy in the morbidly obese. We also describe perioperative characteristics and preliminary outcomes for a limited series of patients who underwent this procedure.
METHODS: We performed a preperitoneal partial mesh underlay with a panniculectomy (PUPP) on 10 patients with incisional hernias and a body mass index (BMI)>40 kg/m(2). The hernia repair was performed by a general surgery team, and the panniculectomy was performed by a plastic surgery team. We retrospectively analyzed perioperative variables for each patient. Phone interviews were conducted to obtain follow-up.
RESULTS: Mean patient age was 53 years (range 32-75 yr) with mean BMI of 46 kg/m(2) (range 41-60 kg/m(2)). Patients had a history of 3.4 average prior abdominal operations, and a median of 3 prior hernia repairs. The average operative time was 371 minutes with a mean estimated blood loss of 162 ccs. Three patients experienced a minor wound complication. There were no major wound complications, and the 30-day mortality rate was zero. At a median and average follow-up time of 805 and 345 days, respectively, one patient developed a hernia recurrence. Patients were satisfied with their appearance and the hernia repair, with mean satisfaction scores of 4.3 and 4.9 out of 5 (very satisfied), respectively.
CONCLUSION: The PUPP hernia repair is a viable option for incisional herniorrhaphy and concurrent panniculectomy in the morbidly obese.
Volume
10
Issue
3
First Page
495
Last Page
501
ISSN
1878-7533
Published In/Presented At
Okusanya, O. T., Scott, M. F., Low, D. W., & Morris, J. B. (2014). The partial underlay preperitoneal with panniculectomy repair for incisional abdominal hernia in the morbidly obese. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 10(3), 495–501. https://doi.org/10.1016/j.soard.2013.07.013
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
24139924
Department(s)
Administration and Leadership
Document Type
Article