Lipomodelling of stoma

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Published: 23 Nov 2016
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Riccardo Bonomi - Western Sussex Hospital Foundation Trust, Worthing, UK

Riccardo Bonomi speaks with ecancertv at NCRI 2016 about improving surgical reconstruction outcomes and quality of life for patients with stoma.

He describes a feasibility study of abdominal reshaping with fat grafts to reduce leaking and improve adhesion of colostomy bags.

We carried out research, one of my main interests is oncoplastic surgery, breast reconstruction, and I’ve been using for several years the fat graft. Because in the past I have been also a general surgeon and I had to deal with patients with stoma I realised how difficult it is for patients who have got stoma to have a good quality of life after being treated for cancer and after having a permanent stoma. When they’ve got leakage it makes the quality of life really poor. So because I’d been using the fat graft to improve the cosmetic outcome in reconstruction and in cosmetic work I thought about a feasibility study that has been approved by an ethical committee and we have published in Colorectal Disease. So in older ladies and in older patients that have got a stoma which is leaking, instead of re-doing the stoma, re-opening the abdomen which is a quite laborious and difficult operation, I did this feasibility study of reshaping the surface of the abdomen doing simply a fat graft in the area where there was no adhesion between the colostomy bag and the skin which was the cause of the leakage. It’s a minimally invasive technique which is apparently working and the patients that we have done are very happy.

How many patients have you done this with?

As a feasibility study we managed to do six and I’m doing one on Wednesday. I’ve got several hospitals that are now interested and we are trying obviously to recruit funding to have funding to do it because it was done all in good will and in free time, basically. But the publication has been accepted in Colorectal Disease, a lot of people are reading it and hopefully we’ll manage to do more cases.