Which surgical techniques are used in the treatment of lipomas?

Updated: Mar 26, 2020
  • Author: Todd A Nickloes, DO, FACOS; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Answer

For more unusual locations, the method of removal must be tailored to the site and may require the expertise of a consultant, as follows:

  • Local removal is indicated in intestinal lipomas causing obstruction or hemorrhage; uncertainty of diagnosis for an intramural intestinal mass also warrants resection, because liposarcomatous disease of the bowel has been described
  • If esophageal lipomas cannot be endoscopically removed, surgical excision is indicated, whether by a transhiatal or a transthoracic approach
  • Lipoma-related narrowing of the major airways warrants removal of the instigating mass; likewise, intraparenchymal lipomas of the lung may require thoracotomy and the expertise of a thoracic surgeon
  • Breast lipomas are excised if their nature is in doubt, whether by means of wire or ultrasonographic localization or by means of direct palpation
  • Vulvar lipomas may be locally excised
  • Lipomas in critical locations, such as the heart, may require a more physiologically and technically demanding procedure for removal, including median sternotomy with bypass
  • Intraosseous lipomas may be removed by means of endoscopy in combination with orthopedic expertise

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