title: Dealing with the mass: a new approach to facilitate panniculectomy in patients with very large abdominal aprons.
abstract: BACKGROUND
  Panniculectomy surgery is performed to remove a massive pannus, or abdominal apron, which frequently contributes to a number of health concerns. The resection of such a massive abdominal panniculus is technically difficult due to the weight of the tissue and the difficulty in handling it during surgery.
  
  
  METHODS
  We performed a retrospective review on 20 morbidly obese patients (14 male, six female) who underwent a panniculectomy with a resection weight of >6 kg between November 2003 and November 2007 at our department.
  
  
  RESULTS
  The patients' weight ranged from 90 to 240 kg, with a mean weight of 157.6 kg. The redundant pannus weighed from 6.8 to 60.0 kg. Uncomplicated healing occurred in 55% of cases. Further complications were not observed.
  
  
  CONCLUSIONS
  The treatment of a massive panniculus requires a multitask management considering optimal conditions for the surgeon and patient. Based on our experience from 20 patients over 4 years, we are able to present our standardized and improved technique using a mechanical lift and a tumescent solution to facilitate this procedure.
authors.affiliation: Department for Plastic and Reconstructive Surgery, Dreifaltigkeits-Hospital, Bonner Strasse 84, 50389 Wesseling, Germany.
authors.forename: Matthias A
authors.initials: MA
authors.lastname: Reichenberger
authors.forename: Alexander
authors.initials: A
authors.lastname: Stoff
authors.forename: Dirk F
authors.initials: DF
authors.lastname: Richter
mesh_terms: D050153:Abdominal Fat / Q000601:surgery*; D000328:Adult; D005260:Female; D006801:Humans; D015187:Lipectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods