Massive Abdominal Pannus
MASSIVE ABDOMINAL PANNUS WITH VENTRAL EPIGASTRIC AND UMBILICAL HERNIA REPAIR
The patient is a 45-year-old African-American female presenting from out of state with significant abdominal wall protrusion. On examination, it was very evident that she had a significant hernia, both in the upper epigastric area as well as the umbilicus. As a result, the patient was scheduled for abdominal CT scan and referred to our general surgeon for consultation for concurrent repair of abdominal hernia repairs with mesh wrap reconstruction and a panniculectomy. The patient underwent the surgery recently with the abdominal wall reconstructed, requiring mesh graft. A mesh graft is important and was placed in order to reduce recurrence of this very large rectus diastasis and significant epigastric hernia. Hernias that are large, especially with abdominal wall diastasis that is severe, usually require reconstruction using a prosthetic mesh graft. A Board Certified General Surgeon is a must when considering abdominal wall reconstruction concurrently with cosmetic or plastic surgery of an abdominal pannus removal.
The hernia is shown which is quite large from the abdominal wall. Preperitoneal fat has been exenterated and the hernia fascial defects have been dissected out. The general surgeon then reconstructs the abdominal wall and the massive abdominal pannus skin is then removed. These surgeries most likely should be performed in a hospital setting in order to allow for intravenous fluid hydration pain management postoperatively. Whenever considering large abdominal protruding abdomens, it is extremely important to preoperatively obtain diagnostic CT scans in order to determine the integrity of the abdominal wall for fascial defect hernias.