Abdominoplasty Repair for Abdominal Wall Hernias

Abstract

The objectives of abdominal hernial repair are to reconstruct the structural integrity of the abdominal wall while minimizing morbidity. Current techniques include primary closure, staged repair, and the use of prosthetic materials. Techniques for abdominoplasty include the use of the transverse lower abdominal incision and the resection of excess skin. By incorporating these aspects into hernial repairs, the procedures are made safer and the results are improved. The medical records were reviewed of 123 consecutive patients who underwent hernial repair. Seventy-six of these patients underwent a total of 82 herniorrhaphies using an abdominoplasty approach. This included using a transverse lower abdominal incision with or without extending it into an inverted-T incision. The hernial defect was then identified and isolated. Repair was obtained with primary fascial closure and plication, primary fascial approximation and reinforcement with absorbable Vicryl mesh, or placement of permanent mesh with or without fascial approximation. Overall, 8 of 82 hernias recurred. Most complications were minor and could be managed with local wound care only. Major complications included one enterocutaneous fistula, one occurrence of skin flap necrosis requiring operative debridement and skin grafting, and one delayed permanent mesh extrusion 2 years after repair. The abdominoplasty approach isolates the incision from the hernial defect and repair. This technique is safe with a low risk of complications and a low rate of recurrence. It is particularly helpful in obese patients, in patients with multiple hernias, and in those patients with recurrent hernias.

Sublay or onlay incisional hernia repair along with abdominoplasty: which is better? Long-term results

“…In both our groups this allowed for the elimination of inflammations under the pendulum fold, observed before IHR and abdominoplasty in all individuals from both groups. This is consistent with observations of other authors [19]. In simultaneous IHR and abdominoplasty, the best option for mesh location and its tissue integration should be under consideration, as it may reduce hernia recurrence.…”

Correção cirúrgica de múltiplas hérnias abdominais associada à abdominoplastia: relato de caso

“…O uso de tela de polipropileno para correção de hérnias abdominais está consolidado, com menos complicações e recidiva 5 . Casos semelhantes foram pesquisados na literatura e não foram encontrados relatos de correções cirúrgicas de múltiplas hérnias associadas à abordagem da abdominoplastia, apenas casos de hérnia única corrigida durante abdominoplastia 6 .…”

Does Abdominoplasty Add Morbidity to Incisional Hernia Repair? A Randomized Controlled Trial

“…7 Abdominoplasty, considered by many general surgeons only as an aesthetic technique has shown to provide great benefits for patients: (1) removal of excessive skin, which promotes better hygiene and reduces skin infections; (2) strengthening of muscular bending (better muscular tone, corporal position, and then de-ambulation); (3) stabilization of the lumbar spine level (by changing the angle of lumbar lordosis and sacral inclination, which improves low back pain), scar removal and, finally, a better perception of our body (higher selfesteem, satisfaction and quality of life), less anxiety, and better personal relationships. [16][17][18][19][20][21][22][23][24][25] All these changes are always desirable for our patients. Cooper et al 26 demonstrated that an abdominoplasty in the setting of a hernia repair can improve patients satisfaction, particularly, appearance, hygiene, and self-confidence.…”