Alex Trelinski
A TEAM at Barcelona’s Sant Pau Hospital has performed the first ‘perfect’ reconstruction of the abdominal wall, so that it recovers all its functionality.
The procedure is the best reconstructive option in cancer patients, affected by radiotherapy or abdominal trauma.
The hospital has already performed five procedures on four sarcoma patients and a woman with serious abdominal wall injuries due to a car accident.
It’s estimated that the hospital will carry out between three and four operations per year on selective patients who have had their abdominal area destroyed by trauma, a tumor or a hernia.
The first patient to go through the procedure has recovered full muscle function after a year.
The operation consists of replacing the affected abdominal muscle with another one from another area of the same patient’s body.
This tends to be either the gracilis or the vastus lateralis muscle (both in the thigh) or the latissimus dorsi, located in the back, depending on the size of the area to be reconstructed.
“These muscles are dispensable, so we use the one that generates the minimum functional and aesthetic consequences,” explained Manuel Fernandez-Garrido from the Sant Pau Plastic Surgery service.
“We model and place the new muscle in the recipient area just where the removed muscle was, and then we join the blood vessels and nerves of the new muscle to those of the recipient area, using the nerve of the original muscle,” he specified.
As soon as the nerves regenerate, the donor muscle performs exactly the same function as the original.
In less than a year, it contracts naturally and maintains the characteristic tone and function of the abdominal wall.
Until now, abdominal wall reconstructions were merely structural and once the tumor (sarcoma) was removed, a mesh was placed to support the internal organs and the area was covered with skin.
“This meant the loss of the muscle that keeps the internal abdominal organs in place and that is essential to perform any natural movement, such as getting up from a chair, for example,” says Fernandez-Garrido.
Patients are able to return to normal life and in some cases there is no difference between the replaced muscle and the original.
