To analyze the safety of laparoscopic ventral hernia delayed repair in bariatric patients with a composite mesh.
Materials and Methods
This retrospective single-center observational trial analyzed all bariatric/obese patients with concomitant ventral hernia who underwent laparoscopic abdominal hernia repair before bariatric surgery (group A) and laparoscopic delayed repair after weight loss obtained by the bariatric procedure (group B).
Group A (30 patients) had a mean BMI of 37.8 ± 5.7 kg/m2 (range: 34.0–74.2 kg/m2); group B (170 patients) had a mean BMI of 24.6 ± 4.5 kg/m2 (range 19.0–29.8 kg/m2) (p < 0.05). Mean operative time: group A, 51.7 ± 26.6 min (range 30–120); group B 38.9 ± 21.5 min (range 25–110) (p < 0.05). Average length of stay: group A, 2.0 ± 2.7 days (range 1–5) versus group B, 2.8 ± 1.9 days (range 1–4) (p > 0.5). Recurrent hernia group A 1/30 (3.3%) versus recurrent hernia group B 4/170 (2.3%) (p > 0.5). Bulging: group A, 3/30 (10.0%) versus group B, 0/170 (0%) (p = 0.23).
The present study demonstrates the safety of performing LDR in patient candidates for bariatric surgery in cases of a large abdominal hernia (W2–W3) with a low risk of incarceration or an asymptomatic abdominal hernia. In the case of a small abdominal hernia (W1) or strongly symptomatic abdominal hernia, repair before bariatric surgery, along with subsequent bariatric surgery and any revision of the abdominal wall surgery with weight loss, is preferable.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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The authors declare that they have no conflicts of interest.
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Olmi, S., Uccelli, M., Cesana, G.C. et al. Laparoscopic Ventral Hernia Repair in Bariatric Patients: the Role of Defect Size and Deferred Repair. OBES SURG 30, 3905–3911 (2020). https://doi.org/10.1007/s11695-020-04747-2
- Laparoscopic ventral hernia repair
- Bariatric surgery
- Sleeve gastrectomy
- Composite mesh