Shipkov Hristo D, Mojallal Ali, Braye Fabienne
Department of Plastic, Reconstructive and Aesthetic Surgery, Croix Rousse Hospital, Lyon, France
Department of Plastic and Craniofacial Surgery, St. George University Hospital, Plovdiv, Bulgaria
Folia Med (Plovdiv). 2017 Jun 1;59(2):222-227. doi: 10.1515/folmed-2017-0026.
Umbilical hernias (UH) are common in postpartum patients seeking abdominal contouring surgery and the question of simultaneous abdominoplasty and UH repair is raised. This presents, however, a risk to the umbilicus vascularisation with possible umbilical necrosis. To minimize this risk we associated abdominoplasty with laparoscopic UH repair. The aim of this study was to present the technique of simultaneous abdominoplasty and UH repair and the first results.
Simultaneous abdominoplasty and laparoscopic mesh UH repair was analysed in the first 10 cases. The intervention was performed by a plastic surgeon and a general surgeon. It begins as a standard abdominoplasty with flap elevation, umbilicus detachment and diastasis repair, if indicated. The second stage is the UH repair via laparoscopy using an intraperitoneal mesh. The third stage consists of umbilical transposition and closure of the abdominoplasty incision.
We had no complications at the umbilicus or the hernia mesh. In all cases, umbilical vascularisation was preserved and no hernia recurrence was noted.
Our first results suggest that the simultaneous UH repair with abdominoplasty is safe, minimizing the risk to the umbilicus blood supply. These first results encourage us to recommend this approach and perform a more detailed analysis of the whole series since our first case.
脐疝（UH）在寻求腹部塑形手术的产后患者中很常见，于是就出现了同时进行腹壁成形术和脐疝修补术的问题。然而，这对脐部血管化存在风险，可能导致脐坏死。为了将这种风险降至最低，我们将腹壁成形术与腹腔镜脐疝修补术相结合。本研究的目的是介绍同时进行腹壁成形术和脐疝修补术的技术及初步结果。
对前10例同时进行腹壁成形术和腹腔镜网片脐疝修补术的病例进行分析。该手术由一名整形外科医生和一名普通外科医生实施。首先进行标准的腹壁成形术，包括掀起皮瓣、分离脐部以及如有必要修复腹直肌分离。第二阶段是通过腹腔镜使用腹膜内网片进行脐疝修补。第三阶段包括脐部移位和关闭腹壁成形术切口。
我们在脐部或疝修补网片处未出现并发症。在所有病例中，脐部血管化得以保留，且未观察到疝复发。
我们的初步结果表明，同时进行脐疝修补术和腹壁成形术是安全的，可将对脐部血液供应的风险降至最低。这些初步结果促使我们推荐这种方法，并自首例病例以来对整个系列进行更详细的分析。
