Surgical Endoscopy

, Volume 28, Issue 4, pp 1209–1212

Concomitant bariatric and ventral/incisional hernia surgery in morbidly obese patients

  • Asnat Raziel
  • Nasser Sakran
  • Amir Szold
  • David Goitein
Article

DOI: 10.1007/s00464-013-3310-z

Cite this article as:
Raziel, A., Sakran, N., Szold, A. et al. Surg Endosc (2014) 28: 1209. doi:10.1007/s00464-013-3310-z

Abstract

Introduction

Ventral hernias are not uncommon in the bariatric population. Their management is technically demanding and remains controversial. Hernia complications can be lethal after bariatric surgery (BS). We herein report our experience with concomitant BS and ventral hernia repair (VHR).

Methods

We performed a retrospective analysis of a prospectively maintained database queried for combined procedures. Hernias were repaired after complete reduction (when the defect was not empty) using a dual mesh fixed to the abdominal wall with absorbable tackers. Data collected included demographics, anthropometrics, co-morbidities, peri-operative course, and intermediate weight loss and co-morbidity status.

Results

Between 2007 and 2012, a total of 54 patients (34 females, mean body mass index 44.2 kg/m2) underwent concomitant BS and VHR. The vast majority of procedures were laparoscopic sleeve gastrectomies (N = 48; 89 %). Others included laparoscopic Roux-en-y gastric bypass (RYGB), open RYGB, and laparoscopic gastric banding (two each). Six patients had complications (11 %): three leaks, two abdominal wall hematomas, and one pulmonary embolism. Hernia recurrence was noted in one patient (1.8 %). Average excess weight loss post-surgery was 49.9 ± 10.3 and 57.7 ± 9.2 % at 6 and 12 months, respectively. The total number of pre-operative co-morbidities was 110. At 12-month follow-up, 50 % (N = 56) were completely resolved and 38 % (N = 42) were improved.

Conclusion

Concomitant BS and VHR is feasible and safe, obviating the need for two separate procedures while not hampering the outcome of either. Complication rates for the combined surgery do not seem to be adversely affected.

Keywords

Bariatric surgery Sleeve gastrectomy Roux-en-Y gastric bypass Ventral hernia 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Asnat Raziel
    • 1
  • Nasser Sakran
    • 1
    • 2
    • 3
  • Amir Szold
    • 1
  • David Goitein
    • 1
    • 4
    • 5
  1. 1.Israeli Center for Bariatric Surgery (ICBS), Assia Medical GroupAssuta Medical CenterTel AvivIsrael
  2. 2.Department of Surgery AEmek Medical CenterAfulaIsrael
  3. 3.Faculty of MedicineTechnion-Israel Institute of TechnologyHaifaIsrael
  4. 4.Department of Surgery CChaim Sheba Medical CenterTel HashomerIsrael
  5. 5.Sackler School of MedicineTel Aviv UniversityTel AvivIsrael

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