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Pre-operative photo.
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We present the case of a 55-year-old woman underwent bariatric surgery in 2014, after which she lost 55 kg of weight (Fig. 1).
Intra-operative photo. We can distinguee two different surgical plane: superficial prefascial (above the Scarpa Fascia) in the infraumbilical region and preaneurotic region in the epigastric portion.
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The skin incision is made according to the preoperative design (Fig. 2), then the abdominal flap is sculpted with ultrasound scalpels.
Plication of the rectus of the abdomen. The adipose-fascial tissue exeresis is noted along the midline of the rectus abdominis.
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Once the tunnel has been completed, the muscle fascia of the rectum is plicated with its approach in the upper abdominal portions, then a medial portion of the adipofascial tissue is removed and the premuscular plane is exposed (Fig. 3).