Resumo

Objectives: Present an effective and safe technique for performing a combined tummy tuck with transposition of the umbilicus and the treatment of a large hernia or eventration by laparoscopy. Introduction: A significant abdominal hernia or eventration may be present in patients requesting abdominoplasty. The treatment typically consists of offering two interventions separated by at least 6 months: the hernia cure by a visceral surgeon and then the abdominoplasty by a plastic surgeon. Publications have been made on laparoscopy repair, concomitant with abdominoplasty, of small umbilical hernias, but not large wall hernias or eventrations. We present a series of patients who have undergone, concomitantly, a laparoscopic hernia cure and an abdominoplasty with umbilical transposition. Materials / method: A prospective series of 31 consecutive patients, operated on by abdominoplasty with umbilical transposition, course of diastasis of the rectus abdominis muscles and most often liposuction combined with the cure of a rupture of the wall under laparoscopy between 2019 and 2023 were included in the study. All the procedures were performed by the same team consisting of a plastic surgeon and a visceral surgeon. Results: 24 patients underwent hernia treatment and 7 underwent laparoscopic eventration treatment. The surface area of the meshes ranged from 9 cm in diameter to 20 X 25 cm. Abdominoplasty with diastasis repair was performed for all patients. Umbilical transposition was performed in 29 patients and neo-umbilicoplasty in 2 cases. The follow-up of at least 6 months does not find any case of recurrence of the hernia or eventration. Diastasis ranged from 45 to 150 mm (mean 80.5 mm). Repair of a hernia or disembowelment took an average of 44 minutes (range 30 to 75 minutes). Conclusion: We present a technique that combines laparoscopic plaque hernia repair and abdominoplasty. Particularly suitable for treating large hernias associated with abdominoplasty indications with transposition of the umbilicus and diastasis treatment, this combination makes it possible to combine two usually separate procedures in a single operating time.