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Novel use and utilization of robotic Hoyer-Hook system for suspension of panniculus morbidus
Aldin Malkoc1, Mark J Landau2, Hailey Shoemaker3
1Department of General Surgery, Kaiser Permanente, Fontana, CA, USA.
Abstract:
Panniculus morbidus is a complication of morbid obesity characterized by massive abdominal folds that hang below the beltline. Ulceration, dermatitis, and sinus tract formation of the pannus can cause significant morbidity to the patient and impair activities of daily living. If patients fail medical management, the next step is surgical excision. Challenging aspects of the procedure include adequate suspension of the pannus, cost, and prevention of intra-abdominal injuries. We present a case of a 70-year-old female with panniculus morbidus with endometrial carcinoma. We successfully performed a panniculectomy using a novel combination of towel hooks and the Hoyer lift to suspend the abdomen. In the same anesthesia event, she underwent robotic-assisted hysterectomy. No intra-operative or post-operative complications were encountered, and the patient was satisfied with her results. In this case, we demonstrated an effective and cost-efficient approach to panniculectomy in the severely obese patient.
Insights
Panniculus morbidus, a complication of severe obesity, can be surgically managed with panniculectomy. This case study details a novel, cost-effective method using towel hooks and a Hoyer lift for abdominal suspension during surgery.
Area of Science:
- Surgical Innovation
- Obesity Complications
- Gynecologic Oncology
Background:
- Panniculus morbidus, characterized by massive abdominal folds, leads to significant patient morbidity including ulceration and dermatitis.
- Surgical excision (panniculectomy) is indicated when medical management fails, but presents challenges in abdominal suspension, cost, and preventing intra-abdominal injuries.
- Obesity significantly increases risks associated with surgical procedures.
Purpose of the Study:
- To present a novel, cost-effective surgical technique for panniculectomy in a patient with panniculus morbidus and endometrial carcinoma.
- To demonstrate the feasibility and safety of combining panniculectomy with robotic-assisted hysterectomy in a single anesthetic event.
- To highlight an innovative approach for suspending the abdominal pannus during surgery.
Main Methods:
- A 70-year-old female patient with panniculus morbidus and endometrial carcinoma underwent a panniculectomy.
- A novel method utilizing towel hooks and a Hoyer lift was employed for effective abdominal suspension.
- The panniculectomy was performed concurrently with a robotic-assisted hysterectomy under the same anesthesia.
Main Results:
- The combined surgical procedure, including the innovative panniculectomy technique, was successfully completed without intra-operative or post-operative complications.
- The patient reported high satisfaction with the surgical outcomes.
- The implemented method proved to be an effective and cost-efficient solution for panniculectomy in a severely obese patient.
Conclusions:
- The novel use of towel hooks and a Hoyer lift provides an effective and economical method for abdominal suspension during panniculectomy in severely obese patients.
- Simultaneous performance of panniculectomy and robotic-assisted hysterectomy is a safe and viable option.
- This approach offers a promising solution for managing the surgical challenges associated with panniculus morbidus.
