Novosti
Khirurgii
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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 University2,
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 Thompsons fascia is necessary.
The analysis of the postoperative course has shown that serious complications from respiratory organs and cardiovascular system werent observed. As a result of liposuction and removal of skin and the apron the weight of a body of patients decreased on 9,542,82 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.

Keywords: abdominoplasty, tension-free hernioplasty, liposuction
p. 101 104 of the original issue
References

1. Brink RR, Beck JB, Anderson CM, Lewis AC. Abdominoplasty with direct resection of deep fat. Plast Reconstr Surg. 2009 May;123(5):1597603.
2. Miziev IA, Alishanov SA. New techniques of abdominoplasty. Khirurgiia (Mosk). 2010;12:6569. [Article in Russian]
3. Ramirez OM. Abdominoplasty and abdominal wall rehabilitation: a comprehensive approach. Plast Reconstr Surg. 2000 Jan;105(1):42535.
4. Brenner J. Mesh materials in hernia repair. Expert meeting on hernia surgery. Basel, Switzerland: Karger; 1995. . 17279.
5. Pitanguy I, Mayer B, Labrakis G. Abdominoplasty--personal surgical guidelines. Zentralbl Chir. 1988;113(12):76571. [Article in German]
6. Worland RG. Tumescent miniabdominoplasty. Ann Plast Surg. 1997 Sep;39(3):332.
7. Colwell AS, Kpodzo D, Gallico GG3rd. Low scar abdominoplasty with inferior positioning of the umbilicus. Ann Plast Surg. 2010 May;64(5):63944.
8. Mest'ak J, Mest'ak O. Miniabdominoplasty. Acta Chir Plast. 2010;52(1):2326.
9. Rodby KA, Stepniak J, Eisenhut N, Lentz CW 3rd. Abdominoplasty with suction undermining and plication of the superficial fascia without drains: a report of 113 consecutive patients. Plast Reconstr Surg. 2011 Oct;128(4):97381.
10. Heddens CJ, Aly AS. What is new in abdominoplasty? Plast Surg Nurs. 2010 Oct-Dec;30(4):20710; quiz 2112.
11. Lockwood TE. Maximizing aesthetics in lateral-tension abdominoplasty and body lifts. Clin Plast Surg. 2004 Oct;31(4):52337.
12. Neliubin PS, Galota EA, Timoshin AD. Khirurgicheskoe lechenie bol'nykh s posleoperatsionnymi i retsidivnymi ventral'nymi gryzhami [Surgical treatment of patients with postoperative and recurrent ventral hernias]. Khirurgiia. 2007;(7):6974.
13. Saenko VM, Belianskii LS, Manoilo NV. Vybor metoda lecheniia gryzhi briushnoi stenki [The choice of treatment method for the abdominal wall hernia]. Klin Khirurgiia. 2002;(1):59.
14. Saldanha OR. Discussion. Abdominoplasty with suction undermining and plication of the superficial fascia without drains: a report of 113 consecutive patients. Plast Reconstr Surg. 2011 Oct;128(4):98283.
15. Stoppa R. Long-term coneplicoktions of prosthetic incisional hernioplasty (Letter). Arch Surg. 1998 Nov;133(11):125455.
16. Fedorov VD, Adamian AA, Gogiia BSh. Lechenie bol'shikh i gigantskikh posleoperatsionnykh ventral'nykh gryzh [Treatment of large and giant postoperative ventral hernias]. Khirurgiia im NI Pirogova. 2000;(1):1114.
17. Zhebrovskii VV, Toskin KD, Il'chenko FN, i dr. Dvadtsatiletnii opyt lecheniia POVG [Twentyyears experience in treatment of POVH]. Vestn Khirurgii im II Grekova. 1996;(2):105108
18. Zhebrovskii VV, Mokhamed TM. Khirurgiia gryzh zhivota i eventeratsii [Surgery treatment for abdominal hernia and eventration. Simferopol, Ukraina: Biznes-Inform; 2002. 449 p.
19. Lukomskii GI, Shulutko AM, Antropova NV. Chastnye aspekty khirurgicheskogo lecheniia posleoperatsionnykh ventral'nykh gryzh [Some aspects of surgical treatment of postoperative ventral hernias]. Khirurgiia. 1995;(1):5153.

Address for correspondence:
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
Information about the authors:
Kosinets V.A., candidate of medical sciences, an applicant for Doctors 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.
Contacts | ©Vitebsk State Medical University, 2007