Suction-assisted lipectomy for the correction of stomal dysfunction

Poorly fitting appliances for urinary or fecal stream stomas can lead to frequent leaking and subsequent social embarrassment, stomal stenosis, hyperkeratosis, skin breakdown, and increased cost secondary to frequent changing. Obese patients with abnormal skin folds frequently are more prone to these problems. Herein is described the use of suction-assisted lipectomy for abdominal wall contouring in an effort to improve and simplify appliance application as well as lengthen appliance life. Between 1989 and 1996, five patients (three females, two males) ages 13 to 47 years, were treated with abdominal wall suction-assisted lipectomy in an attempt to improve stomal function. Preoperatively, an average of 1.25 appliance changes a day were required for leaking. Three patients had one procedure removing 400 to 600 cc of fat. Two patients had staged suction, removing a total of 900 to 1600 cc of fat. At 6-month follow-up, the average appliance life was 4 days, and the incidence of skin problems and leaking was markedly reduced. The technique of suction-assisted lipectomy is a simple outpatient procedure with low morbidity that can successfully be used to improve stomal function in obese patients with poorly fitting appliances secondary to skin folds, poor body habitus, or abdominal scarring.