Abstract:
PURPOSE:An increase in bariatric surgery has led to a rise in postbariatric contouring procedures. Despite a comprehensive preoperative assessment, body habitus in these patients may significantly limit the abdominal exam. Abdominal contouring procedures typically elevate large portions of the skin and fat off the abdominal wall, and unexpected hernia may be discovered intraoperatively. No study to date has characterized such hernia discovery at the time of body contouring surgery. We reviewed our experience of management of incidental hernia found during abdominoplasty or panniculectomy after laparoscopic bariatric surgery. METHODS:Records of all post-bariatric surgery patients undergoing abdominal contouring procedures between 2007 and 2017 were reviewed to identify patients with incidental hernias discovered intraoperatively. These patients were further examined by reviewing operative details, patient-specific factors, and outcomes. RESULTS:Six hundred eighty-one post-bariatric surgery patients underwent abdominal body contouring procedures with incidental ventral hernia discovered in 36 patients (5.3% [45 hernias]). At the time of plastic surgery, average age was 49 years (range, 25-64 years), and body mass index was 30.7 kg/m (range 25-43 kg/m). Of 36 patients with incidental hernia, 26 patients (72.2%) had a single hernia, and the remainder had multiple (27.8%). Mean hernia size was 4.1 cm (range, 0.25-24 cm). Most hernias were located paraumbilical/umbilical (46.7%) or epigastric (37.8%). Ninety-eight percent of hernias were repaired primarily (n = 44) by the plastic surgeon, and in 1 case (2%), mesh repair was performed by a consulting general surgeon. Average follow-up was 1.9 ± 0.3 years. Only 1 patient (2.8%) developed hernia recurrence after 48 months. Other postoperative complications included superficial wound healing problems (19.4%), seroma (16.7%), suture abscess (5.6%), and cellulitis that resolved with antibiotics (5.6%). CONCLUSIONS:This is the first study to characterize incidental hernia discovered at the time of body contouring in the post-bariatric surgery patient. The body contouring surgeon should be aware of this common finding. Hernias typically discovered during panniculectomy or abdominoplasty arise in umbilical or epigastric regions, likely from prior laparoscopic port sites, and can be safely repaired by the plastic surgeon with low overall complication rates.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Levy AS,Dinesh A,Ahmed L,Morrison N,Engdahl Rdoi
10.1097/SAP.0000000000001546subject
Has Abstractpub_date
2018-11-01 00:00:00pages
591-593issue
5eissn
0148-7043issn
1536-3708journal_volume
81pub_type
杂志文章abstract::Five patients with avulsed scalps were treated with replantation between 1992 and 1998. All patients were women age 20 to 36 years. The percentage of the avulsed scalp ranged from 50% to 100% of the whole scalp. The vessels chosen for anastomosis were the superficial temporal artery, occipital artery, and superficial ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200044040-00002
更新日期:2000-04-01 00:00:00
abstract:INTRODUCTION:The traditions of surgical education have changed little over the years. However, the increasing focus on patient safety and duty hour restrictions mandates that residents start developing complex skill sets earlier to ensure they graduate with procedural competency. Surgical training is poised to exploit ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002265
更新日期:2021-02-01 00:00:00
abstract::Thirty-one transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstructions were performed after a delay period either of 1 week (group I, N = 15) or 2 weeks (group II, N = 16). The preliminary delay procedure consisted of bilateral deep inferior epigastric and superficial inferior epigastric artery and...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199704000-00004
更新日期:1997-04-01 00:00:00
abstract::Arterialized venous flaps are the result of the search for new flap techniques because conventional flaps are sometimes insufficient and have donor-site morbidity problems. In the patient presented here, a free arterialized venous flap measuring 12 x 8 cm was transferred from the forearm to a burn-scarred area on the ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199501000-00019
更新日期:1995-01-01 00:00:00
abstract::There has recently been an increase in the usage of the Internet as a source of patient information. It is very difficult for laypersons to establish the accuracy and validity of these medical websites. Although many website assessment tools exist, most of these are not practical.A combination of consumer- and clinici...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000216244.81900.3b
更新日期:2006-09-01 00:00:00
abstract::The authors report a 44-year-old man with inadequate penile girth that caused psychological problems. Using microvascular temporalis fascia transfer, they achieved satisfactory penile girth enhancement based on reliable vascularity in a single stage. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200107000-00016
更新日期:2001-07-01 00:00:00
abstract::A case of multiple symmetric lipomatosis in a 61-year-old man is described. The patient had the striking appearance that characterizes multiple symmetric lipomatosis. He had a history of alcohol abuse. Before admission to our institution, he underwent surgical treatment three times at other hospitals. We describe his ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/00000637-198911000-00015
更新日期:1989-11-01 00:00:00
abstract::A severe case is reported of a rare skin disorder characterized by multiple intracutaneous cystic lesions; the condition is difficult to manage and impossible to cure. The complicating cystic infections that accompany the condition are treated acutely using sound surgical principles, yet long-term management remains a...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198409000-00010
更新日期:1984-09-01 00:00:00
abstract::A new genioplasty technique has been described and performed on 16 patients since 1995. The technique has been developed to avoid some undesired results of the current osseous genioplasty techniques and to achieve a more natural appearance in advancement genioplasty. According to the authors' technique, a rectangular ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1999-08-01 00:00:00
abstract::Deeply invading tumors of the scalp present numerous extirpative and reconstructive problems requiring the combined expertise and skills of both medical and surgical disciplines. We have employed a combined multidisciplinary approach to recurrent tumors of the scalp and calvarium. Intraoperatively, a fresh-tissue mapp...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1980-03-01 00:00:00
abstract::A technique of correction of Stahl's ear is presented and is compared with other techniques reported in the literature. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.SAP.0000067728.84041.96
更新日期:2004-01-01 00:00:00
abstract::We present 8 cases of microvascular reconstruction of the pharynx and cervical esophagus using 5 free ileal transfers and 3 radial forearm flaps. One of the skin flaps underwent a delay procedure a month before transfer. All flaps survived, though there were 2 salivary fistulas that healed spontaneously. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199311000-00010
更新日期:1993-11-01 00:00:00
abstract::Hypertrichosis is an often stigmatizing cosmetic problem not only for women but also for male-to-female transsexual patients. The hitherto described therapeutic measures include chemical epilation, razoring, camouflage, electrolysis and thermolysis, and waxing. All of these measures are transient, more or less painful...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199708000-00009
更新日期:1997-08-01 00:00:00
abstract::The rising rate of MM reflects damage to the skin that has been done in the past. If a difference is to be seen prospectively, we must use protection (sunscreens) and have suspicious areas evaluated early in their course so that MM can be treated when curable. Until further research yields a cure for advanced MM, the ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199201000-00003
更新日期:1992-01-01 00:00:00
abstract::The painful, boil-like lesion of furuncular myiasis is a result of the invasion of subcutaneous tissues by larvae of Dermatobia hominis, the human botfly. This arthropod is indigenous to Mexico, and Central and South America, and imported cases to the United States are increasing as travel to these regions continues t...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/00000637-200102000-00011
更新日期:2001-02-01 00:00:00
abstract::The use of the nasoalveolar molding technique (NAM) aims to reduce passively the width of the alveolar gap, while improving the AP discrepancy but also focusing on the nose. We developed a within-subjects study in which 11 infants with unilateral lip deformity and varying degrees of alveolar gaps were treated by NAM. ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000259001.98869.d8
更新日期:2007-11-01 00:00:00
abstract::Primary cutaneous and soft tissue angiosarcoma is a rare but highly aggressive malignancy. To date, surgical resection is the mainstay of treatment, but poor prognosis is expected. To investigate whether there are factors associated with poor prognosis after surgical resection and to develop a treatment guideline for ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001004
更新日期:2017-03-01 00:00:00
abstract::The first reports on gender-confirming surgery had been published in Germany in the 1920s, but it took some 30 years before sex reassignment surgery for transsexuals became generally known. Initially, such surgery was performed mostly in Europe and Casablanca. In 1956, the gynecologist Dr Georges Burou (1910-1987) ind...
journal_title:Annals of plastic surgery
pub_type: 传,历史文章,杂志文章
doi:10.1097/01.sap.0000258974.41516.bc
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:The need for preoperative imaging as well as anastomotic technique (ie, end-to-side [ETS] vs end-to-end [ETE]) are areas of controversy in microsurgical lower-extremity reconstruction. The objective of this study was to (1) investigate whether preoperative imaging is mandatory and (2) to elicit if the type o...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000002227
更新日期:2020-04-01 00:00:00
abstract::Seroma formation at the donor site of the transverse rectus abdominis myocutaneous flap was evaluated in 48 patients who underwent breast reconstruction with either quilting sutures and suction drains (QS+DN group) or quilting sutures alone (QS group) or suction drains alone (DN group). Clinical and ultrasound examina...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SAP.0b013e3182610b11
更新日期:2014-04-01 00:00:00
abstract::According to most of the literature, sutures for microarterial repair must include the intima to prevent an "intimal flap" and occlusion of the anastomosis. Some authors have said that vessel diameter affects patency rate. This study was designed to evaluate these two statements. The femoral arteries (about 1.0 mm in ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-197903000-00010
更新日期:1979-03-01 00:00:00
abstract::Intravascular coagulation is the final common pathway of failure in replanted digits and "free" tissue transfers. To address this clinical problem, a model based upon intimal damage and stasis in the rat femoral vein was developed. The ability of local, intraarterially administered Thrombolysin to achieve "local" clot...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198107000-00006
更新日期:1981-07-01 00:00:00
abstract:INTRODUCTION:Allograft use has increased recently with the rising use of allograft materials in breast surgery. There are few data that compare the performance of the various allograft materials in this application, despite marketing efforts by the manufacturers to present one allograft material as superior to another....
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318281aece
更新日期:2013-09-01 00:00:00
abstract::Oronasal fistula formation is a recalcitrant complication following palatoplasty, resulting in nasal emission during speech and deglutition. We review our series to identify factors associated with fistula incidence. A retrospective review of all children with nonsyndromic cleft palate who underwent 2-flap palatoplast...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318199669b
更新日期:2009-12-01 00:00:00
abstract::A rare congenital anomaly of the face has been encountered and reported: lateral nasal proboscis. It is characterized by a trunk-like tube arising from an eyelid and is coupled with hypoplasia of the nose, abnormal orbit and maxilla, and ophthalmic anomalies. The pathogenesis and treatment of this disorder are discuss...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1986-03-01 00:00:00
abstract::Regional node dissection is practiced as a measure of prophylaxis in patients with stage I and II malignant melanoma. Although the drainage pattern of the extremities is obvious, in the head and neck and trunk it may be ambiguous. We have used lymphoscintigraphy to assist in delineating the lymphatic drainage in 22 pa...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198902000-00011
更新日期:1989-02-01 00:00:00
abstract::Severe, work-related hand injuries are often accompanied by a significant number of psychological symptoms that are frequently associated with posttraumatic stress disorders. These symptoms occur in the following four domains of psychological functioning: cognitive, affective, physiological, and behavioral. This study...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199212000-00010
更新日期:1992-12-01 00:00:00
abstract::The perforator flaps are characterized by their thinness and the adjustable length of their vascular pedicle. The purpose of this investigation is to refine the anatomy of the perforators in the middorsoradial forearm and present our clinical experience using this free perforator flap in the reconstruction of finger d...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181d3772e
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:Common upper body findings after massive weight loss (MWL) include breast ptosis, projection loss, flattening, inframammary fold descent, and back rolls. Although implants address volume loss, manifestations of circumferential excess (ie, back rolls) are ignored. We review our experience with extended late...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000413
更新日期:2015-05-01 00:00:00
abstract::Clinical care is often directed at improving patient's quality of life, the effectiveness of which can be measured by objective or subjective outcomes. Surgical intervention, especially in plastic and reconstructive surgery, can often provide hard objective measures, for example, breast size reduction after bilateral ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001894
更新日期:2019-09-01 00:00:00