Abdominoplasty in prune belly syndrome: Modifications in Monfort technique to address variable patterns of abdominal wall weakness.

摘要: Introduction Abdominoplasty is an important component of the management children with prune belly syndrome (PBS). While there are features abdominal defect in PBS which common to all patients, will be differences unique each patient that should taken into consideration surgical planning. Specifically, we have come realize although Monfort procedure assumes a symmetric pattern wall laxity, this symmetry rarely present. Objective The aim report describe our modifications and review outcomes for more completely address correction laxity including both uncommon while positioning umbilicus anatomically correct position (Figure). Study design Sixteen male patients one female pseudoprune patient, aged 2–9 years, were treated at institution between 2003 2014. Modifications incorporated abdominoplasty applied study group included: 1) use diagnostic laparoscopy define topography defect, 2) initial midline rather than elliptical skin incision defer retailoring coverage until final step procedure, 3) varying width central plate side asymmetry redundancy, 4) plication reduce vertical redundancy reposition umbilicus, 5) focal areas fascial weakness, most often flank region. Results All improved contour uniform weakness mean follow-up 5.5 years (range 18 months–11.5 years). All parents indicate they very satisfied outcome their procedures without any revisions being performed. This descriptive nature retrospective, population relatively fashion does not allow direct comparison other techniques. Conclusions The modified recognizes muscular deficiency incorporates information design. Figure.  (A) Asymmetric right > left. (B) Midline extent subcutaneous dissection delineated. (C) Full thickness flaps raised from surface. (D) Central developed, right aspect wider. infraumbilical formed. (E) Closure shifts inferiorly. (F, G) Excess removed, brought back together completes procedure. Figure options Download full-size image Download high-quality image (660 K) Download as PowerPoint slide