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VR-8
(VS)
ABDOMINOPLASTY IN PRUNE BELLY SYNDROME (PBS)
Francisco DENES, Roberto LOPES, Rubens PARK, Paulo MOSCARDI and Miguel SROUGI
University of Sao Paulo Medical School Hospital, Urology, São Paulo, BRAZIL
PURPOSE
Many patients with PBS require abdominoplasty alone or associated to correction of the urogenital abnormalities. This
video presents a simplified technique to treat the abdominal flaccidity in PBS.
MATERIAL AND METHODS
With the patient in supine, a longitudinal xypho-pubic fusiform figure is drawn on the abdomen, calculated by
approximation of the redundant abdominal wall to the midline. It represents the area of skin and subcutaneous to be
removed. This is performed with preservation of the musculo-fascial layer and the circumcised umbilicus. A lateral
elliptical single xypho-pubic line is drawn in the most lax side of the fascia, which is incised along this line. After urinary
tract reconstruction and orchidopexy, closure is initiated by suturing the medial edge of the wider fascial flap laterally to
the peritoneal side of the contralateral flap. Next, the now outer fascial flap is laid over the inner flap, and a button-hole
is made to expose the umbilicus. The subcutaneous of the inner flap is undermined laterally to gain extra distance for
the suture of the outer flap over the inner flap. The subcutaneous and the skin are sutured in the midline without
tension, incorporating the umbilicus.
RESULTS
Between 1985 and 2015, 43 PBS patients underwent this procedure with improvement of abdominal size and tonus,
without infection or dehiscence. Temporary umbilical necrosis was observed in 4 cases and keloid in 3 patients.
CONCLUSIONS
This abdominoplasty technique is simple and presents good functional and cosmetic results in PBS patients.