Panniculectomy: an alternative approach to the revision of a difficult stoma.

[AIM] We describe a modified abdominoplasty technique as an alternative approach to the revision of a difficult stoma.

[METHOD] A patient with a retracted colostomy secondary to change in abdominal wall contour following significant weight loss was treated with this technique. The patient had previous colostomy revision with marlex mesh insertion for combined parastomal and massive ventral hernia repair. A preoperatively marked crescent shaped left upper quadrant segment of skin and subcutaneous fat was excised and the defect was approximated in multiple layers. This shifted the stoma opening cephalad and eliminated the cutaneous crease that originally made it difficult to obtain a proper stoma seal.

[RESULTS] At one year follow up the patient was extremely satisfied with the results and was able to properly pouch the stoma.

[CONCLUSION] Modified abdominoplasty can be used as an alternative, low morbid approach in dealing with selected patients with difficult stoma problems.