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Outcomes of concomitant ventral hernia repair performed during bariatric surgery

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An Erratum to this article was published on 12 September 2016

Abstract

Background

Currently there is no consensus on management of ventral hernias encountered during bariatric surgery (BS). This study aims to evaluate the incidence and outcomes of concomitant ventral hernia repair (VHR) during BS at our institution.

Methods

Patients who had concomitant VHR during BS from 2004 to 2015 were identified. Data collected included baseline demographics, comorbidities, perioperative parameters, surgical approach and postoperative outcomes.

Results

A total of 159 patients underwent concomitant VHR during the study period at the time of BS. One hundred and one (64 %) patients were female; median age was 53 years (IQR 45.0–60.3) and median BMI was 48.2 kg/m2 (IQR 41.6–54.1). Comorbidities included: hypertension (n = 124, 78 %), type 2 diabetes (n = 103, 65 %), hyperlipidemia (n = 100, 63 %), obstructive sleep apnea (n = 98, 62 %) and reflux disease (n = 54, 34 %). Out of 159 patients, 41 patients (26 %) had a prior VHR. Out of 103 patients, 69 patients (67 %) had a previous abdominal surgery. Of the concomitant VHR, 144 (91 %) were completed laparoscopically, 12 (7 %) patients were converted to open surgery and 3 (2 %) patients underwent primary open procedures. Technique included primary suture closure in 115 (72 %) and mesh repair in 44. Early postoperative complications (<30 days) were reported in 16 (10 %) patients, with superficial wound infection (n = 9), bowel obstruction (n = 2), marginal ulcer (n = 2), DVT (n = 1) and pneumonia (n = 1). Hernia recurrence was reported in 3 patients (2 %) in the early post-op period and in 40 patients (25 %) as a late (>30 days) complication. Surgery for recurrent hernia was performed in 31/42 patients during follow-up. At 12-month follow-up, median BMI and % excess weight loss were 34.2 kg/m2 (IQR 29.5–40.9) and 59.6 % (IQR 44.9–74.8 %), respectively.

Conclusion

Ventral hernia is a common finding in patients undergoing BS. Both primary suture repair and mesh repair result in acceptable results, both in terms of recurrence and perioperative complications.

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Author’s contribution

Gautam Sharma was involved in study concept, data collection and analysis, abstract and manuscript writing. Mena Boules was involved in study concept, data collection and manuscript writing. Suriya Punchai was involved in study concept and data collection. Andrew Strong was involved in data collection and analysis. Dvir Froylich was involved in study concept and original review. Zubaidah Nor Hanipah was involved in final review. Colin P. O’Rourke was involved in data analysis. Stacy A. Brethauer was involved in final review. John Rodriguez was involved in study concept and final review. Kevin El-Hayek was involved in study concept and final review. Matthew Kroh was involved in study concept, data analysis and final review.

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Authors and Affiliations

  1. Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave/A100, Cleveland, OH, 44195, USA

    G. Sharma, M. Boules, S. Punchai, A. Strong, D. Froylich, N. H. Zubaidah, C. O’Rourke, S. A. Brethauer, J. Rodriguez, K. El-Hayek & M. Kroh

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  1. G. Sharma
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  2. M. Boules
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Correspondence to G. Sharma.

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Disclosures

Gautam Sharma, Mena Boules, Suriya Punchai, Andrew Strong, Dvir Froylich, Zubaidah Nor Hanipah, Colin P. O’Rourke, Stacy A. Brethauer, John Rodriguez, Kevin El-Hayek and Matthew Kroh have no conflicts of interest or financial ties to disclose.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s00464-016-5237-7.

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Sharma, G., Boules, M., Punchai, S. et al. Outcomes of concomitant ventral hernia repair performed during bariatric surgery. Surg Endosc 31, 1573–1582 (2017). https://doi.org/10.1007/s00464-016-5143-z

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