Definition
Removal of loose, redundant abdominal skin and underlying subcutaneous fat, and repair of the rectus muscle as necessary.
Discussion
- The procedure is performed for cosmetic purposes, to reduce a disproportionately large collection of fat in the abdomen.
- It should not be performed for weight reduction.
- A variety of techniques can be used according to the fat distribution and the surgeon’s preference.
Positioning
- Supine, with arms extended on armboards.
Packs/ Drapes
- Basic pack with transverse Lap sheet.
Instrumentation
- Basic plastic tray
- Extra Criles or Kochers may be needed.
Supplies/ Equipment
- Basin set
- Suction
- Scales for weighing specimens
- Blades
- Needle counter
- Drainage unit
Procedure
- An incision is made just above the inguinal fold, “aW” which is extended on the umbilicus, creating a diamond shape.
- The umbilicus is preserved for later replacement under the flap.
- Dissection is usually begun at the lower portion of the W incision and progress upward, leaving a fine layer of areolar tissue over the fascia.
- Each lateral branch of tissue is excised.
- The amount predetermined before removal so that the defect can be closed with moderate tension.
- If there is a separation of the rectus muscle, it is repaired by taking “tucks” to shorten the muscle.
- If a large ventral hernia is present, it may be repaired with synthetic mesh.
- The wound is closed with heavy absorbable suture (deep fat) and a running subcutaneous suture.
- The vertical branches are closed first, and the umbilicus is repositioned in the vertical scar.
- The use of drains is according to the surgeon’s preference.
Perioperative Nursing Considerations
- Strict aseptic technique must be maintained.
- Weigh and record the weight of the specimen.
- Encourage the patient not to make strenuous activities.
