July 22, 1974

Removal of Panniculus Adiposus

Author Affiliations

Des Moines, Iowa

JAMA. 1974;229(4):391. doi:10.1001/jama.1974.03230420013002

To the Editor.—  Jejunoileostomy, with or without the concomitant removal of a large panniculus adiposus, is increasingly popular in the treatment of morbid obesity. Methods of removal of a large abdominal apron, some weighing as much as 36 kg (80 lb), are receiving attention in the surgical literature.Steinmann pins attached to Kirschner wire retractors,1 hydraulic lifts,2 Crutchfield tongs with block and tackle,3 and a rigid bar containing screw eyes4 have been employed to elevate the panniculus during surgery.Meyerowitz et al5 placed two Rush pins through the panniculus and suspended it through a block and tackle on the operating room ceiling.I use a technique that incorporates an overhead bar from the Albee Orthopedic operating table. The bar, which is 144 cm (57 inches) in length and rectangular in cross section, 2.5 × 3.75 cm (1 × 1 1/2 inch), is sterilized and then