Dealing with the Mass: A New Approach to Facilitate Panniculectomy in Patients with Very Large Abdominal Aprons

Background Panniculectomy surgery is performed to remove a massive pannus, or abdominal apron, which frequently contributes to a number of health concerns. The resection of such a massive abdominal panniculus is technically difficult due to the weight of the tissue and the difficulty in handling it during surgery. Methods We performed a retrospective review on 20 morbidly obese patients (14 male, six female) who underwent a panniculectomy with a resection weight of >6 kg between November 2003 and November 2007 at our department. Results The patients' weight ranged from 90 to 240 kg, with a mean weight of 157.6 kg. The redundant pannus weighed from 6.8 to 60.0 kg. Uncomplicated healing occurred in 55% of cases. Further complications were not observed. Conclusions The treatment of a massive panniculus requires a multitask management considering optimal conditions for the surgeon and patient. Based on our experience from 20 patients over 4 years, we are able to present our standardized and improved technique using a mechanical lift and a tumescent solution to facilitate this procedure.