Incisional abdominal hernia repair with concomitant abdominoplasty: Maintaining umbilical viability

• Main Authors: Robert Phan, Elan Kaplan, Jemma K. Porrett, Yik-Hong Ho, Warren M. Rozen
• Format: Article
• Language: English
• Published: Elsevier 2018-06-01
• Series: JPRAS Open
• Online Access: http://www.sciencedirect.com/science/article/pii/S235258781730058X

Introduction: Abdominoplasty and abdominal hernia repair are often carried out in two-stage procedures, and those describing single-stage surgery require careful dissection to preserve often only partial blood supply to the umbilicus to maintain its viability. This paper aims to describe the surgical method of laparoscopic umbilical hernia repair in association with abdominoplasty. Case presentation: A patient presents with an incisional hernia at a previous periumbilical port site of size 14 x 9 mm observed on ultrasound as well as a recurrent left inguinal hernia from previous bilateral laparoscopic inguinal hernia repair, oophorectomy, and laparoscopic cholecystectomy. A laparoscopic mesh repair of the hernia defect followed by abdominoplasty was performed. The patient made an uncomplicated recovery and was discharged home on day 5 post operation. There was complete healing of the umbilicus and remainder of the wounds. At 24-month follow-up, there was no recurrence of hernia. Conclusion: Previously documented methods of concomitant abdominoplasty and hernia repair use an open technique to repair the hernia. A laparoscopic approach is faster, but it poses a significant risk to the vascular supply to the umbilicus. This not only increases positive aesthetic outcomes and patient satisfaction but also reduces rates of postoperative complications and recovery time. Keywords: Abdominoplasty, Hernia repair, Umbilical viability, Laparoscopic, Mesh