Novel use and utilization of robotic Hoyer-Hook system for suspension of panniculus morbidus

Abstract

Panniculus morbidus is a complication of morbid obesity characterized by massive abdominal folds that hang below the beltline. Ulceration, dermatitis, and sinus tract formation of the pannus can cause significant morbidity to the patient and impair activities of daily living. If patients fail medical management, the next step is surgical excision. Challenging aspects of the procedure include adequate suspension of the pannus, cost, and prevention of intra-abdominal injuries. We present a case of a 70-year-old female with panniculus morbidus with endometrial carcinoma. We successfully performed a panniculectomy using a novel combination of towel hooks and the Hoyer lift to suspend the abdomen. In the same anesthesia event, she underwent robotic-assisted hysterectomy. No intra-operative or post-operative complications were encountered, and the patient was satisfied with her results. In this case, we demonstrated an effective and cost-efficient approach to panniculectomy in the severely obese patient.

Keywords: Hoyer lift; Morbid obesity; Obesity; Panniculectomy; Panniculus morbidus.

Figure 1

(A) Golvo 8008 Hoyer Lift placed at the foot of the bed to facilitate ease of pannus suspension with towel clamps placed to effectively lift the asymmetric pannus (B) Pannus adequately lifted and ready for sterilization (C) Complete removal of the pannus.