The treatment of lipomas by the "squeeze" technique
Barry PoweII andN R McLean
Published in the Journal of Royal College of Surgeons 1985
Department of Plastic, reconstructive and burns Surgery, Queens mary's Hospital, Roehampton Lane, London SW15 5PN.
A simple technique for the removal of lipomas through a small stab incision is described.
The treatment of lipomas is rarely mentioned in the surgical literature, meriting only four lines in "Farquharson's" Textbook of Operative Surgery" Traditionally they are removed through a skin crease incision over the most prominent part of the swelling which may leave a large, unsightly and cosmetically unacceptable scar even in the hands of the most skilled surgeon.
We describe a simple method for the removal of lipomas through a small stab incision which gives an extremely satisfactory cosmetic result.
Method: The limits of the tumour are drawn on the skin surface and a small stab incision made in the skin and deepened to penetrate the deep capsule of the lipoma (Figs 1 and 2). It is important that the deep aspect of the capsule is cut through or the tumour will not present through the wound. The lipoma is then squeezed between the surgeon's finger and thumb and mushrooms out of the incision (Figs 3a and b) In large lipomas both hands are frequently required to express the fatty lump.
Removal is completed with scissors (Fig. 4) a small drain is inserted if required and the skin is sutured with subcuticular prolene (Fig 5).
This technique has been used by us on 12 patients although it has been practised for several years by those who introduced us to the method.
Results: There have been no haematomas, wound breakdowns and only one recurrence in a patient with a large diffuse lipoma over the shoulder. All patients have been pleased with the final cosmetic result.
Discussion: Removal of a lipoma is usually left to the most junior member of the surgical team and consists of excision through a fairly large incision which may give an ugly cosmetic result. More recently liposuction has been used for the treatment of localised fatty tissue but this technique requires specialised equipment and expertise.
We have found that removal of lipomas using the squeeze technique is quick, safe and effective, gives an excellent cosmetic result and is easily learned and carried out by the most junior member of the surgical team. It can be used on both the discrete and the diffuse forms of the disease, though we have found it more applicable to tumours with well defined edges. Large lipomas can be removed through relatively small incisions usually under a general anaesthetic as the squeezing can elicit local pain and tenderness. If the tumour is large the use of both hands may be required.
We strongly recommend the squeeze technique as a simple and effective method of removing lipomas.
Acknowledgments: We wish to thank Mr A Rossi and Mr P K B Davis, Consultant Plastic Surgeons, who introduced us to this technique.
Referance:
- 1 Rintoul R F. Farquharson's textbook of operative surgery 6th edn. Edinburgh Churchill - livingstone 1978 II.
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