A novel method of pannus suspension during massive panniculectomy

Morbidly obese patients are often burdened by a massive abdominal pannus that can only be addressed with a panniculectomy. However, as its size and weight increase, pannus handling during surgery becomes a real challenge for the surgeon and his/her assistants. We describe a case where we use a novel method of pannus suspension, the Spider Tenet, a limb positioner for orthopedic procedures.This device allows a stable pannus suspension throughout the procedure to facilitate incision planning, skin preparation, and retraction, as well as to increase exposure, thereby facilitating the identification and ligation of large blood vessels during dissection. The Spider Tenet has the advantage of being easy and quick to set up and operate, and it is readily covered with sterile drapes, thus decreasing the risk of contamination during a surgery.With increasing rates of obesity, we can expect that the demand for abdominal panniculectomies will rise. We introduce the use of a device that eliminates the technical challenges encountered during massive panniculectomy while reducing operative time and morbidity. More importantly, it allows the solo surgeon to carry out this procedure without additional hands other than the scrub nurse.