Formations in the thickness of the wall
Abdominal wall formations require an accurate preoperative assessment (ultrasound/MSCT): depth, connection with the aponeurosis and muscles, difference from a hernia. The desmoid is excised with an indentation (prone to local recurrence), endometrioma of the scar - with the area of the affected aponeurosis (relieves cyclic pain), ligature granulomas - with the removal of old suture material. Aponeurosis defects are sutured or covered with mesh in the same operation. Histology determines observation; Relapses with adequate indentation are rare.
Indications
- lipomas, atheromas, fibromas of any location - growth, discomfort, aesthetics;
- skin formations requiring histology (traumatable nevi, keratomas, basal cell carcinomas in agreement with the oncologist);
- formations of the anterior abdominal wall (desmoid, postoperative granulomas);
- formation of the abdominal cavity in combination with the adhesive process.
Why remove with histology
Any removed formation must be examined under a microscope - this is the only way to exclude rare but important findings (liposarcoma in a “lipoma”, basal cell carcinoma in a “mole”) and confirm the completeness of the removal. Surgical excision within healthy tissue with a capsule is the only way to avoid recurrence of atheromas and lipomas. Minor procedures are performed on an outpatient basis in 20–30 minutes with a cosmetic suture; large and deep - with a hospital and anesthesiologist.
