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Repair of ventral hernias in morbidly obese patients undergoing laparoscopic gastric bypass should not be deferred

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Abstract

Background: There is no consensus regarding the optimal treatment of ventral hernias in patients who present for weight loss surgery. Methods: Medical records of consecutive morbidly obese patients who underwent laparoscopic Roux-en-Y (LRYGB) gastric bypass with a secondary diagnosis of ventral hernia were reviewed. Only patients who were beyond 6 months of follow-up were included. Results: The study population was 85 patients. There were three groups of patients according to the method of repair: primary repair (59), small intestine submucosa (SIS) (12), and deferred treatment (14). Average follow-up was 26 months. There was a 22% recurrence in the primary repair group. There were no recurrences in the SIS group. Five of the patients in the deferred treatment group (37.5%) presented with small bowel obstruction due to incarceration. Conclusion: Biomaterial mesh (SIS) repair of ventral hernias concomitant with LRYGB resulted in the most favorable outcome albeit having short follow-up. Concomitant primary repair is associated with a high rate of recurrence. All incarcerated ventral hernias should be repaired concomitant with LRYGB, as deferment may result in small bowel obstruction.

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Authors and Affiliations

  1. Minimally Invasive Center, Department of Surgery, University of Pittsburgh Medical Center, Suite 5500, Magee-Women’s Hospital, 300 Halket Street, Pittsburgh, PA 15213, USA

    G. M. Eid, S. G. Mattar, G. Hamad, D. R. Cottam, J. L. Lord, A. Watson, M. Dallal & P. R. Schauer

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  1. G. M. Eid
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  2. S. G. Mattar
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  3. G. Hamad
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  4. D. R. Cottam
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  5. J. L. Lord
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  6. A. Watson
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  7. M. Dallal
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  8. P. R. Schauer
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Correspondence to G. M. Eid.

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Eid, G., Mattar, S., Hamad, G. et al. Repair of ventral hernias in morbidly obese patients undergoing laparoscopic gastric bypass should not be deferred. Surg Endosc 18, 207–210 (2004). https://doi.org/10.1007/s00464-003-8915-1

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  • DOI: https://doi.org/10.1007/s00464-003-8915-1

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