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Modified abdominoplasty for patients with the Prune Belly syndrome
Francisco Tibor Dénes1, Roberto Iglesias Lopes1, Lorena Marçalo Oliveira1
1Division of Urology, University of São Paulo Medical School, São Paulo, Brazil.
Insights
This study introduces a novel abdominoplasty technique for Prune Belly syndrome (PBS) patients, achieving excellent cosmetic and functional outcomes. The procedure effectively improves abdominal tonus and appearance in children with this rare congenital condition.
Area of Science:
- Pediatric Surgery
- Urology
- Plastic Surgery
Background:
- Prune Belly syndrome (PBS) is a rare congenital disorder characterized by abdominal muscle deficiency, urinary tract abnormalities, and cryptorchidism.
- Abdominoplasty is a crucial component of surgical management for PBS, aiming to improve abdominal wall function and aesthetics.
Purpose of the Study:
- To present the outcomes of a new abdominoplasty technique in pediatric patients diagnosed with Prune Belly syndrome.
- To evaluate the safety, efficacy, and cosmetic results of this innovative surgical approach.
Main Methods:
- A cohort of 46 children with PBS underwent surgical treatment including urinary tract reconstruction (UTR), orchidopexy, and abdominoplasty.
- The described abdominoplasty technique involves specific steps for musculo-aponeurotic fascia (MAF) repair and skin closure, preserving the umbilicus.
Main Results:
- Excellent skin coaptation was achieved in all 41 patients who underwent the new abdominoplasty technique, with no need for trimming or instances of dehiscence or skin necrosis.
- Immediate improvement in abdominal tonus and appearance was observed, with further enhancement noted during growth in most patients.
Conclusions:
- The presented abdominoplasty technique is effective and applicable across all forms of abdominal wall weakness associated with Prune Belly syndrome, including asymmetrical presentations.
- The procedure yields favorable cosmetic and functional results, requiring only a single MAF incision.
Objective:
To present the results of a new technique for abdominoplasty in patients with the Prune Belly syndrome (PBS).
Methods:
Since 1985, 46 children with PBS underwent surgical treatment that included urinary tract reconstruction (UTR), orchidopexy, and abdominoplasty. In 41 patients, we performed the abdominoplasty as follows: (1) fusiform longitudinal resection of the mid-abdominal skin and subcutaneous tissue, with preservation of the musculo-aponeurotic fascia (MAF) and umbilicus, (2) ellipsoid unilateral longitudinal incision of the MAF in the most weakened side of the abdomen, producing 2 flaps, with the umbilicus being kept intact in the widest flap, (3) after UTR and bilateral orchiopexy, suture fixation of the widest MAF layer to the inner side of the contralateral abdominal wall, creating an inner MAF layer, (4) lateral suture fixation of the other flap over the inner layer, creating an outer MAF layer with a buttonhole exposing the umbilicus, that is sutured to the outer layer, and (5) approximation of the skin edges with incorporation of the umbilicus in the suture.
Results:
Skin coaptation was excellent in all patients, and no trimming was necessary in incision extremities. There was no dehiscence or skin necrosis and all patients presented immediate improvement of the abdominal tonus and appearance. Further improvement with growth was observed in all except 4 patients, 2 requiring secondary abdominoplasties.
Conclusion:
We conclude that this technique is applicable in all forms of weakened abdomen typical of PBS, even in asymmetrical cases, requiring only 1 MAF incision, with good cosmetic and functional results.
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