Novosti
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Year 2012 Vol. 20 No 2
EXCHANGE BY EXPERIENCE
V.A. KOSINETS 1, I.P. SHTURICH 2, E.A. UKRAINETS 3
EXPERIENCE OF COMBINED ABDOMINOPLASTY AND TENSION-FREE HERNIOPLASTY OF THE ANTERIOR ABDOMINAL WALL
SEE HPE “First Moscow Medical University” named after I.M.SECHENOV 1,
The Russian Federation
EE “Vitebsk State Medical University”2,
ME “Vitebsk regional clinical hospital” 3,
The Republic of Belarus
Objectives. To improve the results of surgical treatment of patients with anatomo-functional insufficiency of anterior abdominal wall.
Methods. 21 patients at the age from 33 till 52 with the presence of belly ptosis and hernial defect of the anterior abdominal wall of various localizations were operated on. In all cases a classical abdominoplasty was performed. The choice of the technique and direction of displacement of a flap were defined according to the expressiveness of skin and fat «apron». In 75% cases abdominoplasty was supplemented with liposuction of lateral departments of the anterior abdominal wall. Tension-free hernioplasty was carried out on «inlay» method with the application of partially resolving facilitated multifilament grids VYPRO (Johnson & Johnson, Ethicon).
Results. Classical abdominoplasty is evident to patients with the expressed changes of the anterior abdominal wall. Additional performance of liposuction allows generating a natural contour of the waist, and also gets rid of necessity of wide lateral separation of skin and fat flap, thus saving vessels feeding it. At allocation of skin and fat flap for the purpose of preventive maintenance of lymphorrhea preservation out of a seams zone of a fatty cellulose lower than Thompson’s fascia is necessary.
The analysis of the postoperative course has shown that serious complications from respiratory organs and cardiovascular system weren’t observed. As a result of liposuction and removal of skin and the «apron» the weight of a body of patients decreased on 9,54±2,82 kg.
Conclusions. Thus, abdominoplasty permits to obtain technically convenient access at tension-free hernioplasty of the anterior abdominal wall of any localization. Combined performance of abdominoplasty and tension-free hernioplasty of the anterior abdominal wall allows achieving simultaneously good esthetic and functional result. Abdominoplasty combined with liposuction of the lateral sections of the anterior abdominal wall permits to achieve more natural and esthetically attractive contour of a belly.
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119991, Rossiiskaia Federatsiia, g. Moskva, ul. Iauzskaia, d. 11, GOU VPO “Pervyi Moskovskii gosudarstvennyi meditsinskii universitet im. I.M. Sechenova”, kafedra obshchei khirurgii,
e-mail: vkosinets@yandex.ru,
Kosinets Vladimir Aleksandrovich
Kosinets V.A., candidate of medical sciences, an applicant for Doctor’s degree of the chair of general surgery of I.M. Sechenov First Moscow State Medical University.
Shturich I.P., candidate of medical sciences, associate professor of the hospital surgery chair of EE “Vitebsk State Medical University”.
Ukrainets E.A., a head of the 1st surgical department of ME “Vitebsk regional clinical hospital”.
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