The safety and efficacy of extensive abdominal panniculectomy at the time of pelvic surgery.

Nine massively obese patients underwent excision of a large abdominal panniculus in conjunction with pelvic surgery. The most frequent indication for surgery was endometrial cancer. The charts of the patients were reviewed with careful attention to the outcome of the operation and the postoperative course. Comparison was made to previously reported data. The patients ranged in age from 48 to 72 years (mean 56). Weight range was 216 to 325 pounds (mean 261) and averaged more than twice ideal body weight. The weight of the resected abdominal wall was 3900 to 11,000 grams (mean 6247). Hospital stay ranged from 6 to 18 days (mean 8.2). Postoperative complications were chiefly those associated with the dead space created by the large resection without flap undermining (seromas in 2 and wound infections in 3). Four patients required prolonged wound drainage as outpatients. The average length of time to complete wound healing was 40.3 days (range 10 to 65). There were no dehiscences, pulmonary emboli, or operative mortalities. No patients required reoperation. Our study demonstrates that it is possible to safely combine plastic and gynecologic surgery without significantly increasing operative time, blood loss, postoperative complications, or hospital stay.