Utilization of an Omental J-Flap in Complex Gynecological Surgeries

Abstract

Objective:

The goal of this research was to evaluate the clinical outcomes of performing pedicled omental J-flap omentoplasty in gynecologic patients.

Materials and Methods:

This retrospective observational study occurred at a tertiary-care medical center in Staten Island, NY, from October 16, 2009 to December 17, 2015. Consecutive patients who underwent omentoplasty with an omental J-flap during their index gynecologic surgeries were included. Electronic medical records were reviewed to collect data on patient demographics, intraoperative and perioperative outcomes, and clinical outcomes.

Results:

A total of 27 women (mean age: 46.1 years; range: 24-81 years) underwent omentoplasty using pedicled omental J-flaps. The majority of these surgeries were performed laparoscopically (23; 85.2%). The omental J-flaps were used after extensive dissection and denuding in 16 patients (59.3%); and following repair of bladder injury in 5 patients (18.5%), bowel injury in 3 patients (11.1%), and ureteral injury in 3 patients (11.1%). There were no intraoperative or immediate postoperative complications at 2-week and 6-week follow-ups. Long term follow-up >6 weeks occurred for 24 (88.8%) of patients. The median time of follow-up was 76.4 months (range 2–136 months). No complications of omental-flap necrosis, cuff dehiscence, or fistula formation occurred.

Conclusions:

The inherent physiologic properties of the omentum, and the anatomical feasibility and safety of omentoplasty warrant possibly using omental J-flaps in complex gynecologic surgeries to augment revascularization and healing. (J GYNECOL SURG 38:33)