Intra abdominal pressure changes in meshplasty and abdominal wall plication techniques in abdominoplasty: a comparative study


  • Ramya Thulaseedharan Pillai Department of General Surgery, Amala Institute of Medical Sciences, Amala Nagar, Thrissur, Kerala, India
  • Varghese Joseph Department of General Surgery, Amala Institute of Medical Sciences, Amala Nagar, Thrissur, Kerala, India
  • Krishnakumar Marar Department of General Surgery, Amala Institute of Medical Sciences, Amala Nagar, Thrissur, Kerala, India



Abdominoplasty, Mesh plasty, Rectus plication, Intra-abdominal hypertension, Abdominal compartment syndrome


Background: Measurement of intra abdominal pressures is used to identify patients at risk of intra-abdominal hypertension and abdominal compartment syndrome after abdominoplasty that may lead to tight closure of the abdomen. This comparative study was aimed at measuring the IAP of patients in groups of meshplasty and abdominal wall plication, intraoperatively and post operatively.

Methods: A comparative study was conducted among 34 patients who underwent meshplasty and abdominal wall plication. Each group comprised of 17 patients. All preoperative blood investigations and pre anesthetic evaluations were done. The technique used is decided based on the soft tissue laxity, rectus diastasis and presence of ventral hernias. Intra operatively, IAP was measured soon after the placement of mesh or after Rectus plication and post operatively, IAP was measured within 24 hours. IAP was measured using the intra vesical technique using Foley’s Catheter.

Results: Fifty percent of the total patients were in the age group 41-50yrs and 88.2% of the patients were females. No significant variations in IAP, either intraoperative (p=0.051) or post operative (p=0.202), was evidenced in both groups. Post operatively, patient developed minimal complications such as seroma collection, wound infection and respiratory complications, improving on symptomatic treatment and antibiotics.

Conclusions: No significant intraoperative or postoperative IAP was found between the two study groups underwent meshplasty and abdominal wall placation techniques.

Author Biography

Varghese Joseph, Department of General Surgery, Amala Institute of Medical Sciences, Amala Nagar, Thrissur, Kerala, India

Dr. Varghese Joseph

Assistant Professor of General Surgery

Department of General Surgery

Amala Institute of Medical Sciences

Amala Nagar, Thrissur-680 555


Kelly HA. Report of gynecological cases. Johns hopkins Med J. 1899;10:197.

Cosmetic Surgery National Data Bank. Available at: Accessed on 14 October 2018.

Cheatham ML. Abdominal compartment syndrome: pathophysiology and definitions. Scand J Trauma Resusc Emerg Med. 2009;17:10.

Pereira N, Sciaraffia C, Danilla S, Parada F, Asfora C, Moral C. Effects of Abdominoplasty on Intra-Abdominal Pressure and Pulmonary Function. Aesthetic Surg J. 2016;36(6):697-702.

Talisman R, Kaplan B, Haik J, Aronov S, Shraga A, Orenstein A. Measuring Alterations in Intra-Abdominal Pressure During Abdominoplasty as a Predictive Value for Possible Postoperative Complications. Aesthetic Plast Surg. 2002;26(3):189-92.

De Keulenaer BL, De Waele JJ, Powell B, Malbrain MLNG. What is normal intra-abdominal pressure and how is it affected by positioning, body mass and positive end-expiratory pressure? Intensive Care Med. 2009;35(6):969-76.

Malbrain ML, Cheatham ML, Kirkpatrick A, Sugrue M, Parr M, De Waele J, et al. Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. Intensive Care Med. 2006;32(11):1722-32.

Grazer F. Abdominoplasty. McCarty JG, May JW, Littler JW, eds. Plastic Surgery. Philadelphia, Pa: WB Saunders; 1990:6;3929.

Flesch-Thebesius M WK. Die operation des hangebauches. Chirurg. 1931;(3):372.

Wilhelmsson S, Fagevik Olsén M, Staalesen T, Elander A, Nygren-Bonnier M. Abdominal plasty with and without plication-effects on trunk muscles, lung function, and self-rated physical function. J Plast Surg Hand Surg. 2017;51(3):199-204.

Blickstein D, Blickstein I. Oral contraception and thrombophilia. Curr Opin Obstet Gynecol. 2007; 19(4):370-6.

van Vlijmen EFW, Brouwer J-LP, Veeger NJGM, Eskes TKAB, de Graeff PA, van der Meer J. Oral contraceptives and the absolute risk of venous thromboembolism in women with single or multiple thrombophilic defects. Arch Intern Med. 2007; 167(3):282.

Andrades P, Prado A, Danilla S, Guerra C, Benitez S, Sepulveda S, et al. Progressive tension sutures in the prevention of postabdominoplasty seroma: a prospective, randomized, double-blind clinical trial. Plast Reconstr Surg. 2007;120(4):935-46.

Marques A, Brenda E, Abramo A, Amarante M. Abdominoplasty without plication of the aponeurosis. Eur J PlastSurg. 1996;19(2):89-91.

Ghnnam W. Abdominoplasty for ventral abdominal hernia mesh repair AGORA (Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections). Available at: Accessed on 14 October 2018.

Gaidukov KM. Effect of intra-abdominal pressure on respiratory function in patients undergoing ventral hernia repair. World J Crit Care Med. 2013;2(2):9.

Angelici AM, Perotti B, Dezzi C, Amatucci C, Mancuso G, Caronna R, et al. Measurement of intra-abdominal pressure in large incisional hernia repair to prevent abdominal compartmental syndrome. Edizioni Internazionali. 2016;37(1):31-6.

Sugrue M, Buist MD, Lee A, Sanchez DJ, Hillman KM. Intra-abdominal pressure measurement using a modified nasogastric tube: Description and validation of a new technique. Intensive Care Med.1994;20(8): 588-90.

Kim J, Stevenson TR. Abdominoplasty, liposuction of the flanks, and obesity: analyzing risk factors for seroma formation. Plast Reconstr Surg. 2006;117(3): 773-9.

Vastine VL, Morgan RF, Williams GS, Gampper TJ, Drake DB, Knox LK, et al. Wound complications of abdominoplasty in obese patients. Ann Plast Surg. 1999;42(1):34-9.

Tadiparthi S, Shokrollahi K, Doyle GS, Fahmy FS. Rectus sheath plication in abdominoplasty: Assessment of its longevity and a review of the literature. J Plast Reconstr Aesthetic Surg. 2012; 65(3):328-32

José Muaccad Gama L, Vinicius Jardini Barbosa M, Czapkowski A, Ajzen S, Masako Ferreira L, XerfanNahas F. Single-layer plication for repair of diastasis recti: the most rapid and efficient technique level of evidence. Aesthetic Surg J. 2017;37(6):698-705.

Huang GJ, Bajaj AK, Gupta S, Petersen F, Miles DAG. Increased Intraabdominal Pressure in Abdominoplasty: Delineation of Risk Factors. Plast Reconstr Surg. 2007;119(4):1319-25.






Original Research Articles