Incisional Hernia Repair with Abdominoplasty

Background: Abdominoplasty is considered by many general surgeons as only an aesthetic technique. It has shown to provide great benefits for patients: (1) removal of excessive skin, which promotes better local hygiene and reduces incidence of skin infections; (2) strengthening of muscular bending (better muscular tone, corporal position, and then de-ambulation); (3) stabilization of the lumbar spine level (by changing the angle of lumbar lordosis and sacral inclination, improving the chronic low back pain), scar removal and, finally, a better perception of their bodies (higher selfesteem, satisfaction and quality of life), less anxiety and better personal relationships. All these changes are always desirable for all patients. Aim of the Work: The main objective of our study is to assess the outcome of the combined procedure of abdominoplasty and incisional hernioplasty, compared to incisional hernioplasty alone. Patients and Methods: This randomized comparative study was carried out on fourty patients having incisional hernias in General Surgery and Plastic Surgery Departments in Ain Shams University and AL Salam Specialized Hospital. Hernias are included in this study and divided into two groups, each group formed of 20 patients. First group (group A) with patients underwent hernioplasty alone and the other group (group B) with patients underwent combined hernioplasty with abdominoplasty. Patients are explained that they have the right to refuse joining to the research or withdraw at any time without affecting their chances to receive the optimal treatment at any time. Patients are explained the significant risks and the problems specific to them as well as the likely outcome if complications occurred and the relevant treatment options as well as the risks of not having the procedure. Results: According to size of hernia hernioplastywas 4.20 and abdominoplasty was 5.45. According to type of suture PDS loop hernioplasty was15.0%, abdominoplasty was 75.0% and Prolene hernioplasty was 85% abdominoplasty was 25%. Conclusion: Abdominoplasty can be performed in combination with hernia repair in patients with incisional hernias, especially when associated with large sized defects or divercation of recti. Simultaneous techniques can be safely performed with the same morbidity and recurrences, but with major quality of life improvement and superiority over hernioplasty alone.