Limberg Flap (Rhomboid Flap)
A rhomboid-shaped transposition flap reconstructs the natal cleft after wide excision of pilonidal sinus - effective for large defects, complex disease, or recurrence after prior surgery. Available at Lux Hospitals, Hyderabad.
What is Limberg Flap (Rhomboid Flap)?
The Limberg Flap (Rhomboid Transposition Flap) transposes a rhomboid-shaped flap of skin and subcutaneous tissue from an adjacent area to fill the surgical defect after wide pilonidal sinus excision - closing it under no tension with the scar placed completely off the midline.
Dr. Samhitha Reddy uses the Limberg Flap at Lux Hospitals, Hyderabad for complex primary pilonidal disease with large defects, recurrent disease after prior excision, and cases where the Karydakis Flap does not provide adequate tissue. As part of the advanced pilonidal sinus treatment surgery in Hyderabad programme, it provides excellent tissue volume and reliable off-midline closure.
The Limberg Flap provides excellent tissue volume for larger defects but requires more tissue mobilisation than Karydakis. Active infection must be resolved before flap surgery.
How the Procedure Works
Rhomboid Excision Design
The sinus and all surrounding affected tissue is excised as a rhomboid block. A matching rhomboid flap is designed on the lateral buttock.
Wide Excision
The entire sinus, all pits, tracts, and affected tissue is excised down to the presacral fascia with all margins confirmed clear.
Flap Elevation
The rhomboid transposition flap is elevated with full-thickness skin and subcutaneous fat, preserving adequate subcutaneous tissue depth for blood supply.
Flap Transposition
The flap is rotated into the defect and sutured in place - deep layer with absorbable sutures, skin with interrupted sutures. Suction drain placed.
Donor Site Closure
The donor site is closed directly. Patient is mobilised carefully the next day. Drain removed at 24-48 hours.
Outcomes
Who Needs This Treatment?
- →Provides abundant well-vascularised tissue for large defect closure
- →Places the wound scar completely off the midline - minimal recurrence risk
- →Effective for recurrent disease where prior surgery has depleted local tissue options
- →Primary closure - heals in 3-4 weeks rather than the 6-8 weeks of open excision
- →Very low recurrence rate (<5%) in properly selected cases
- →Available at Lux Hospitals, Hyderabad as part of the comprehensive pilonidal sinus reconstruction programme
The Limberg Flap is a beautifully versatile reconstructive option. Its rhomboid geometry provides generous well-vascularised tissue, and the transposition reliably moves the wound away from the problem midline - making it particularly valuable for the challenging recurrent pilonidal cases.
— Dr. Samhitha Reddy, Consultant Proctologist & Laparoscopic Surgeon, Lux Hospitals, Hyderabad
Limberg (Rhomboid) Flap Surgery Cost in Hyderabad
The cost of Limberg (Rhomboid) flap surgery in Hyderabad depends on the extent of pilonidal disease, size of the defect, complexity of recurrent disease, investigations required, and the care needed before and after surgery.
For patients with large defects or recurrent pilonidal disease, the approximate cost of Limberg (Rhomboid) flap surgery ranges between ₹55,000 and ₹1,00,000.
| Procedure | Approximate Cost Range |
|---|---|
| Limberg (Rhomboid) Flap | ₹55,000 – ₹1,00,000 |
The final cost may vary depending on your individual condition, findings during evaluation, and whether any additional procedures are required.
Factors That Influence Limberg (Rhomboid) Flap Cost
The overall cost may depend on:
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Complexity of pilonidal disease: The size of the defect, extent of recurrent disease, previous surgeries, scar tissue, and infection status may influence the treatment approach and surgical planning.
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Pre-operative evaluation: Required investigations, clinical examination, and medical assessments before surgery may affect the overall cost.
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Additional procedures: If procedures such as removal of infected tissue, abscess drainage, or other pilonidal sinus management procedures are required, the cost may vary.
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Hospital stay and post-operative care: The duration of admission, wound care, medicines, and follow-up requirements may influence the final estimate.
Is Limberg (Rhomboid) Flap Covered by Insurance?
Limberg (Rhomboid) flap surgery may be covered by health insurance when it is performed for a medically necessary condition. Coverage depends on your insurance policy, inclusions, and approval process.
Our insurance support team can assist you with checking your policy coverage, required documentation, cashless approval process, and insurance-related queries before the procedure.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Samhitha Reddy
Consultant Proctologist & Laparoscopic Surgeon
During consultation, Dr. Samhitha Reddy, Proctologist and Colorectal Specialist in Hyderabad, will evaluate your symptoms, medical history, and investigation reports to determine whether Limberg (Rhomboid) flap surgery is suitable for you. She will explain the procedure, expected outcomes, and guide you regarding the estimated cost based on your individual condition and treatment requirements.
Common Questions
Frequently Asked Questions
Not sure which treatment is right for you?
Book a consultation with Dr. Samhitha Reddy and get a personalised treatment plan.