“Supersize” Panniculectomy

Pestana, Ivo A.; Campbell, Douglas; Fearmonti, Regina M.; Bond, Jennifer; Erdmann, Detlev

doi:10.1097/sap.0b013e31827f5496

Cited by 15 publications

(1 citation statement)

References 15 publications

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“…[10][11][12][13][14][15] Although panniculectomy is a beneficial procedure, it carries a moderate risk of complications. We found an overall complication rate of 40% in our series, which is consistent with prior reports ranging from 40% to 56% [16][17][18][19][20] ; however, half of these complications were managed in the clinic setting. In smokers, the complication rate is 49%.…”

Section: Discussionsupporting

confidence: 91%

Evaluating Outcomes and Weight Loss After Panniculectomy

et al. 2021

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Objective The objective of this study was to evaluate long-term outcomes and weight loss after panniculectomy. Methods A retrospective chart review study was performed on 225 consecutive patients who had undergone panniculectomy from 2002 and 2020. Demographic variables including smoking status, medical comorbidities, and prior history of weight loss/bariatric surgery were collected for 173 patients. Preoperative and postoperative body mass index (BMI) were calculated in addition to postoperative outcomes. Results The study population was 85% female with a mean age of 57 years and an average follow-up of 3.9 years. Relevant comorbidities included obesity (88%), hypertension (65%), diabetes (37%), and smoking (8%), and the majority (53%) of patients had undergone prior bariatric surgery. The overall complication rate was 40%. Twenty percent of patients required reoperation or readmission, and 20% had minor complications addressed in an outpatient setting. Patients who had higher preoperative BMI experienced a significant long-term reduction in BMI. In addition, patients who did not undergo prior bariatric surgery tended to lose weight more often and by larger amounts than patients who had prior bariatric surgery (71.6% vs 57.6, P = 0.023). Complications were not uncommon and included infection (17%), delayed wound healing (16%), seroma (8%), and hematoma (3%). Patients who had prior bariatric surgery were at reduced risk of any complication (P = 0.012). Smoking increased the incidence of infection (38.5% of smokers vs 15.6% of nonsmokers, P = 0.039). Concomitant hernia repair increased the risk of overall complications (64.3% vs 35.9%, P = 0.003) and delayed wound healing (39.2% vs 11.7%, P < 0.001). In the subgroup of patients who did not lose weight, a panniculus weight greater than 5 kg was associated with an increased complication rate (61.5% vs 27%, P = 0.03). Conclusions Patients who underwent a panniculectomy tended to lose weight postoperatively, particularly those who had not undergone previous bariatric surgery. Complications were not uncommon, especially in patients with a smoking history. Prior bariatric surgery patients had a significant decrease in postoperative complications but tended to lose less weight after panniculectomy than those without prior bariatric surgery. Concomitant hernia repair put patients at an increased risk of complications.

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Section: Discussionsupporting

confidence: 91%

Evaluating Outcomes and Weight Loss After Panniculectomy

et al. 2021

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Body Contouring After Duodenal Switch

Beidas

2023

Duodenal Switch and Its Derivatives in Bariatric and Metabolic Surgery

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Extreme—Super obesity and panniculectomy: bipolar radiofrequency scalpel assisted surgery as a valuable option for the most challenging cases

Susini,

Pozzi,

Marcaccini

et al. 2024

Eur J Plast Surg

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Background In Italy, with a cohort of 6.3 million morbidly obese patients, panniculectomy is often necessary both in relation to bariatric surgery and as the sole treatment to reduce excess lower abdominal tissues. At first glance, the procedure could be misjudged as technically simple; however, when considering patients with Extreme obesity or worse (BMI > 40 kg/m2), the surgical risks increase significantly, patients are often inoperable, and few studies are available in the literature. Most surgeons actually avoid this job and related risks. Recent research has highlighted a potential role of the Bipolar Radiofrequency Scalpel (BRS) in various fields as a promising tool to reduce surgical complications. With this paper, the authors report their experience in the management of panniculectomy in Extreme (BMI > 40 kg/m2) and Super (BMI > 50 kg/m2) obese patients through the technique of BRS assisted panniculectomy. Methods A retrospective study was conducted on Extreme / Super obese patients who underwent BRS assisted panniculectomy between June 2013—June 2022. The panniculectomy involved lower abdomen excess skin and soft tissues removal, assisted by BRS, minimal undermining, and eventual abdominal hernia repair. Surgical procedures, and complications rate are discussed. Results Fourteen patients matched the selection criteria and were included in the study. Minor and major complications occurred in 28,6% and 14,3%, respectively. No flap necrosis, infections, cellulitis or decubitus ulcer occurred. Seroma 28,6% (4/14) and hematoma 7,1% (1/14) were the most relevant complications in the study population. Conclusions BRS assisted panniculectomy with minimal undermining is a valuable option for patients with extreme or super obesity. At the time of dissection, minimizing undermining and using BRS could make the operation safer and therefore extendable to a larger cohort of patients. Level of evidence: Level IV, Therapeutic; Risk/Prognostic.

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“Supersize” Panniculectomy

Cited by 15 publications

References 15 publications

Evaluating Outcomes and Weight Loss After Panniculectomy

Evaluating Outcomes and Weight Loss After Panniculectomy

Body Contouring After Duodenal Switch

Extreme—Super obesity and panniculectomy: bipolar radiofrequency scalpel assisted surgery as a valuable option for the most challenging cases

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