Abdominoplasty and simultaneous laparoscopic ventral hernia repair. Clinical study about 45 patients

• Published in: Annales de chirurgie plastique et esthétique 2017-04, Vol.62 (2), p.115-121
• Main Authors: Le Gall, H., Reibel, N., De Runz, A., Epstein, J., Brix, M.
• Format: Article
• Language: English
• Subjects: Abdominoplastie; Abdominoplasty; Abdominoplasty - methods; Adult; Cohort Studies; Combined Modality Therapy; Cœlioscopie; Female; Hernia; Hernia, Ventral - surgery; Hernie; Humans; Laparoscopy; Laparoscopy - methods; Male; Middle Aged; Patient Care Team; Postoperative Complications - etiology; Prothèse; Retrospective Studies; Surgical Mesh; Umbilicus - surgery; Ventral; Éventration
• ISSN: 0294-1260; 1768-319X
• DOI: 10.1016/j.anplas.2016.06.005

Abdominoplasty procedures sometimes reveal the presence of ventral hernias (umbilical or trocar-site hernias). Our objective is then to deal with the excess abdominal skin and fat tissue at the same time as the ventral hernia. This can be done with a single surgical procedure combining abdominoplasty with umbilical transposition and laparoscopic ventral hernia repair (LVHR) with mesh. The main objective of our study is to assess the outcome of the combined procedure of abdominoplasty and LVHR with mesh, compared to abdominoplasty alone. A retrospective single-centre cohort study was conducted, including patients operated on with the combined method (ABDO-LVHR group) and patients who underwent abdominoplasty alone (ABDO group). We noted major and minor complications, with infection issues as our main concern. We included 15 patients in the ABDO-LVHR group and 30 in the ABDO group. The results show no statistically significant difference for infectious complications in the ABDO-LVHR group compared to the ABDO group (20% vs 3.3%; P=0.100). There was no instance of complete umbilical necrosis. Other major and minor complications occurred at the rates typically described in the literature without difference between the two groups. There was no significant difference between our two groups in terms of infectious complications. LVHR carried out at the same time as abdominoplasty with umbilical transposition is a positive combination of procedures. Further studies are necessary to confirm that the risk in terms of infectious complications is no higher than for abdominoplasty alone. III. Il n’est pas rare lors d’une abdominoplastie de constater un défect pariétal péri-ombilical (hernie ombilicale ou éventration). L’excès cutanéo-graisseux abdominal et le défect pariétal peuvent être traités simultanément en combinant une abdominoplastie avec transposition ombilicale et la cure du défect pariétal par voie cœlioscopique avec pose de prothèse (laparoscopic ventral hernia repair [ABDO-LVHR]). Nous avons souhaité étudier l’incidence des complications chez les patients bénéficiant de cette procédure combinée par rapport à ceux bénéficiant d’une abdominoplastie seule. Nous avons mené une étude de cohorte rétrospective monocentrique, incluant des patients ayant bénéficié de la procédure combinée (groupe ABDO-LVHR) et des patients ayant bénéficié d’une abdominoplastie seule (groupe ABDO). Nous avons recensé les complications majeures et mineures, avec comme critère principa