Panniculectomy - Revision history

Dominicmangino: Added additional indications, time frames, positioning details, additional preoperative considerations for this population

2025-09-10T00:02:22Z

Added additional indications, time frames, positioning details, additional preoperative considerations for this population

← Older revision		Revision as of 17:02, 9 September 2025
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	=== Indications<!-- List and/or describe the indications for this surgical procedure. --> ===		=== Indications<!-- List and/or describe the indications for this surgical procedure. --> ===
	Commonly done after rapid weight loss from (≥ 100lb/45kg) after bariatric surgery.		Commonly done after rapid weight loss from (≥ 100lb/45kg) after bariatric surgery. Can also be done in patient's with excess abdominal tissue leading to SSTI (e.g., necrotizing fasciitis)

	=== Surgical procedure<!-- Briefly describe the major steps of this surgical procedure. --> ===		=== Surgical procedure<!-- Briefly describe the major steps of this surgical procedure. --> ===
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	\|-		\|-
	\|Pulmonary		\|Pulmonary
	\|OSA		\|OSA, potential with rapid desaturation during hypoventilation with body habitus
	\|-		\|-
	\|Gastrointestinal		\|Gastrointestinal
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	\|-		\|-
	\|Endocrine		\|Endocrine
	\|		\|DM often poorly controlled
	\|-		\|-
	\|Other		\|Other
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	=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===		=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===
	Fat emboli		Fat emboli, DVT, Infection, wound dehiscence

	== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==		== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==
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	\|-		\|-
	\|Position		\|Position
	\|		\|Supine
	\|		\|
	\|-		\|-
	\|Surgical time		\|Surgical time
	\|		\|1-5hr
	\|		\|
	\|-		\|-
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	\|-		\|-
	\|Potential complications		\|Potential complications
	\|		\|ileus, infection, dehiscence, DVT
	\|		\|
	\|}		\|}

Jashvin at 20:02, 7 November 2022

2022-11-07T20:02:35Z

← Older revision		Revision as of 13:02, 7 November 2022
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	\|-		\|-
	\|Pulmonary		\|Pulmonary
	\|~~Obesity~~		\|OSA
	\|-		\|-
	\|Gastrointestinal		\|Gastrointestinal

Jashvin: Started new page on panniculectomy

2022-11-07T19:49:52Z

Started new page on panniculectomy

New page

{{Infobox surgical procedure
| anesthesia_type = General
| airway = ETT
| lines_access = PIV x 1 (18G)
| monitors = Standard, 5-lead EKG
| considerations_preoperative = Obesity
| considerations_intraoperative = Positioning, fat emboli
| considerations_postoperative = Smooth emergence with minimal bucking to minimize tension on suture line
}}

Panniculectomy is a surgery done to remove stretched out, excess fat and overhanging skin from your abdomen. This can occur after a person undergoes massive weight loss. The skin may hang down and cover your thighs and genitals. Surgery to remove this skin helps improve your health and appearance.

Panniculectomy is different from abdominoplasty. In abdominoplasty, the surgeon will remove extra fat and also tighten your abdominal (belly) muscles. Sometimes, both types of surgery are performed at the same time.

== Overview ==

=== Indications ===
Commonly done after rapid weight loss from (≥ 100lb/45kg) after bariatric surgery.

=== Surgical procedure ===

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
|Obesity
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Pulmonary
|Obesity
|-
|Gastrointestinal
|H/o bariatric surgery, full stomach
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies ===

=== Operating room setup ===

=== Patient preparation and premedication ===

=== Regional and neuraxial techniques ===

== Intraoperative management ==

=== Monitoring and access ===
Standard monitoring

=== Induction and airway management ===
Standard induction for healthy patients.

Consider rapid sequence intubation in obese patients, those with GI pathology or repeated abdominal surgeries.

Consider video laryngoscopy.

=== Positioning ===

=== Maintenance and surgical considerations ===
Standard maintenance.

Take care when calculating drug doses (lean body mass vs actual body mass)

=== Emergence ===
Smooth emergence. Avoid bucking to minimize tension on suture lines.

Ensure adequate PONV prophylaxis.

== Postoperative management ==

=== Disposition ===
PACU

=== Pain management ===
IV narcotics

=== Potential complications ===
Fat emboli

== Procedure variants ==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Indications
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|~100cc
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References ==

[[Category:Surgical procedures]]