Surgical Technology International XVI - Surgical Overview
Article title:
Abdominal Dermolipectomy in Laparotomy with Stoma Surgery: Case Report






Masaki Yazawa, M.D., Ph.D.
Medical Director,
Plastic and Reconstructive Surgery


Kenjiro Kotake, M.D.
Department Manager, Surgery


Takashi Matsui, M.D.
Medical Director, Surgery


Souta Asaga, M.D.
Medical Staff, Surgery


Tochigi Cancer Center, Tochigi, Japan

In cases of morbid obesity, excessive soft tissue in the abdomen forms an apron-like deformity called panniculus because of rapid weight loss due to cancer. In laparotomy with stoma aimed at cancer resection, obesity is reported as a major risk factor of stoma complications, one of the most frequent of which is necrosis. In one patient in whom a laparotomy was performed through a midline incision, the authors also carried out an abdominal dermolipectomy aimed at reducing distortion of the abdominal wall in relation to the stoma. This procedure provided two important advantages for stoma surgery, stability, and better postoperative care by the patient.



In cases of morbid obesity, excessive soft tissues in the abdomen form an apron-like deformity made worse by rapid weight loss caused by cancer.1 In patients who undergo laparotomy with stoma formation due to cancer resection, the apron-like deformity is an obstacle to stoma surgery and stoma care. In stoma surgery, obesity is a major risk factor of complications.2,3 Some studies have reported revision of stoma in excessive obesity patients.4 Abdominal dermolipectomy offers considerable advantages in stoma surgery and stoma care. This Case Report is of a morbid obesity patient who had an apron-like deformity in the abdomen. In this patient, at the time of laparotomy through an abdominal midline incision, an abdominal dermolipectomy to improve stoma surgery was performed.