pedicle tram flap/abdominal buldge complication

[absintheminded]

Wondering how many woman suffering severe abdominal bulge/weakened stomach wall and severe digestive issue's years post pedicle tram flap? I am finally finding some admittance of this severe and debilitating side effect. Not many Dr's seem to want to associate it with the pedicle tram flap or acknowledge this very serious complication. Granted, in 2004 this was a relatively new surgery, we could not know all side effects. However, I seem to see this happening not just to me but to others and no one wants to discuss or find a fix. My left side of my abdoman has completely buldged out. This happend in 2011. My surgery was 2004. You can actually see the outline of my intestines. I went to ER thinking I had a severe hernia, possibly a blockage. The "Buldge" had increased greatly in size. Along with this came constipation and pain. It seems I am experiencing on going blockages in my intestines and colon. Without the strength of the rectus muscle my stomach has become so weak it cannot perform the contractions necessary, I beleive, to push the waste through my body. I swell with toxins. I notice it is at its worst when my toes swell from the toxins as well. I have to give up all fiber as I cannot digest it or break it down. I am forced to take laxitaves like milk of magnesia and suppository laxitives at least 2x a week or I develop horrific blockages which I fear can burst and become sepsis. A recent episode last week sent me to the ER where x-rays ordered to be sure blockage passed. It had but the inflammation, pain and gas are horrific. You cannot even touch my left side abdomin without pain. I am not able to eat fruit, vegetables, whole grains etc., I am losing vitamins and now adding ensure to my diet. They say the only possible thing they could do would be to find an abdominal wall specialist to try and tighten it, however I was warned that these surgeries are loaded with serious complications and tend to fail. I'm terrified I'm going to end up on a bag or something. My gastro doctor, primary, etc.,could not answer what was wrong with me...finally a plastic surgeon and my new oncologist says this is a side effect that is just beginning to show up in more and more woman. A warning to other woman, the bulge became it's largest after lifting heavy objects such as heavy grocery bags upstairs...it doesn't take much...you must NEVER lift anhything heavy again...yeah, like that's a possibilty...so, this is kind of a statement to throw out there on a serious side effect of the pedicle tram flap that certainly is being ignored in the medical community...and my question is, is there any hope? Will this neccesety of laxitives (I'm only 50) cause me to be dependent always. If the blockage does not pass can it burst and can I go sepsis? Thank you.


This discussion is related to pedicle tram flap complications.

[absintheminded]

Yes, I am incorrect in stating they were new in 2004...rather new in my area. We were warned about possibilty of hernia for the initial few months.  The new procedure sparing the abdominal rectus muscle has greatly improved and lessened side effects of this surgery. Plastic surgeon told me that they are seeing these "Bulges" (they are not hernia's, weakened abdominal/stretched wall) more and more often. The Plastic surgeon also is the one who told me that repair of the abdominal wall could be attempted with an abdominal wall surgeon, however doubted successfull outcome and warned of even worse side effects.

[Christopher R Watters, MD]

I'm not sure about the "new procedure" in 2004. TRAM flaps have been pretty commonplace since 1980. Hernias are fairly common - especially in the few that had bilateral TRAM flaps. This was well known in 2004. In fact, many plastic surgeons at that time went ahead and performed mesh repairs of the defect in anticipation of the impending hernia. The fact that these procedures were done without entering the peritoneal cavity makes them generally straightforward for laparoscopic repair.

[canthetram]

Please see the new published repair technique by Dr. George Denoto and Dr. Ron Israeli in The Atlas Of Abdominal Wall Reconstruction, Vol. 2, Chapter 21. Published in 2016. There is a reliable proven repair for these ladies. My hope is that more surgeons will adopt their technique. My repair was in May 2013. I developed 3 hernias after a bilateral Tram Flap. I never gave up hope to find a proven long term repair. And I found it. As an RN, I reached out to many surgeons that said there was no such reliable repair or that the hernias most likely would recur. After much reading on their technique, it made sense to me. And I proceeded with repair. These surgeons are on the cutting edge...no pun intended. And have helped and continue to help many women.

[bluebutterfly2222]

Hi,

Sincerely sorry to hear all the difficulties you've been having!

We very frequently hear similar complaints related to the Tran Flap procedure. If you put that term in the search box for this community, you will find countless previous related threads.

We specialize in answering questions about breast cancer and breast health in this community, however, so I'd suggest you post your GI-related medical questions in one of the expert forums, such as Digestive Disorders/Gastroenterology or Cosmetic and Reconstructive Surgery.

Best wishes,
bluebutterfly