Hysterectomy & Panniculectomy Combined In One Surgery?

The September issue of the official medical journal of the American Society of Plastic Surgeons (ASPS) has reported that hysterectomy and panniculectomy - the removal of hanging abdominal fat and skin - may be done at the same surgery.

Cosmetic and gynecological surgeries are commonly performed together at some hospitals. However, surgeons are concerned that performing panniculectomy and hysterectomy together because of the possiblity of increase in the risk of complications.

New studies reveal that there is a similar complication rate between women who chose to undergo a combined panniculectomy and hysterectomy as compared to those who had hysterectomy alone.

Further, the research revealed that:

  • Patients undergoing hysterectomy and panniculectomy were more likely to be obese, to have diabetes, and to have a history of heart or lung disease. 
  • Overall, women undergoing hysterectomy plus panniculectomy had a higher rate of blood clot-related complications called venous thromboembolism (VTE): three percent versus one percent. Women in the combined group were also more likely to stay in the hospital for three days or longer.
  • Comparing the matched groups of patients with similar characteristics, the researchers found no significant difference in VTE risk. There was also no difference in wound complications, surgical site infections, medical complications, or total complication rate.
  • The difference in length of hospital stay remained significant. Women undergoing hysterectomy plus panniculectomy were twice as likely to spend at least three days in the hospital.

According to lead author Dr. Antonio Jorge Forte who performed the research at the Yale School of Medicine:  

This is among the best evidence to date regarding 30-day risk profiles, and the data suggests that the complication rates are comparable for patients undergoing combined hysterectomy and panniculectomy versus hysterectomy alone. In other words, patients may elect to benefit from the convenience of multiple procedures in a single stage associated with the peace of mind of documented safety.

The new study supports the safety of this combined approach. However, these patients should be counseled to expect to stay longer in the hospital after combined procedures. Our findings do not end the conversation about risks associated with combined procedures, but provide more data to help patients and providers make informed decisions.

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