Abdominal reduction following jejunoileal bypass for morbid obesity

We present six patients who underwent abdominal reduction after successfully losing weight following jejunoileal bypass. Three patients needed more than one operation to achieve a good cosmetic result. There were no serious complications. After reviewing these patients and the few previously reported cases we make the following suggestions: 2 years should elapse after a stable weight is attained before surgery. Preoperative metabolic screening is essential. Preoperative marking of the lines of excision, prophylactic antibiotics and drainage of the wounds are strongly recommended. Lower abdominal aprons may be safely removed by a low transverse incision extended laterally up to the iliac crests and superiorly as far as the umbilicus. The umbilicus can be resited without risk of necrosis. High abdominal aprons should be excised as a transverse or vertical "melon-slice" ellipse without undermining.