Apronectomy with repair of large ventral hernia in a morbidly obese patient

Abstract

A 42 year old female with a body mass index of 47 presented to the general surgical outpatient clinic with a large apron of skin hanging from the anterior abdominal wall. This adversely affected her mobility and was prone to intertrigo. It was also complicated by the presence of a large ventral hernia with propensity for recurrent incarceration. Apronectomy with repair of ventral hernia was performed A novel technique to anchor the heavy apron was employed. The apron was anchored to an overhead steel bar by means of large orthopaedic Steinman’s pins and stirrups. A total of 18.5 kg of skin and soft tissue were removed. The patient had difficulty in weaning off the ventilator and spent 3 weeks in the intensive care unit. There were no other complications. There was marked improvement in her mobility and overall quality of life after the operation. Apronectomy can be safely performed in conjunction with ventral hernia repair. This method of anchoring the apron greatly facilitates an otherwise difficult operation. The number of operators as well as the operating time is reduced.