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Concomitant Bariatric Surgery with Laparoscopic Intra-peritoneal Onlay Mesh Repair for Recurrent Ventral Hernias in Morbidly Obese Patients: an Evolving Standard of Care

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Abstract

Background and Aims

Repair of recurrent ventral hernias (RVHs) has a high failure rate more so in the presence of obesity. The chronic increase in intra-abdominal pressure (IAP) associated with obesity might, in part, be an important implicating factor that needs to be addressed in these patients. Laparoscopic ventral hernia repair (LVHR) done with concomitant bariatric surgery in morbidly obese patients with RVHs may avoid multiple failures.

We report our preliminary experience in treating RVHs in morbidly obese patients with laparoscopic intra-peritoneal onlay mesh (IPOM) repair and concomitant bariatric surgery.

Methods

A retrospective review of all patients with a RVH who underwent concomitant bariatric surgery and laparoscopic IPOM repair at our institution from 2009 to 2013 was performed. Demographic, operative, postoperative, and follow-up data were collected.

Results

There were 23 patients included in the study. The mean BMI was 43.24. Fifteen patients had a previous open mesh repair, and eight had a laparoscopic IPOM repair. The patients had a median of 2 previous repairs (range 1–5 repairs). A laparoscopic sleeve gastrectomy was performed in 22 patients, and a laparoscopic Roux-en-Y gastric bypass was performed in one. The mean operating time was 112 min (65–220 min). The mean hospital stay was 3.3 days (2–8 days). A seroma was noted in four patients. No mesh infection or recurrence was noted at a median follow-up of 3.3 years (9 months to 5.5 years).

Conclusion

Laparoscopic IPOM repair done with concomitant bariatric surgery in morbidly obese patients with RVHs seems promising with a low rate of early recurrence.

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Compliance with Ethical Standards

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Conflict of Interest

The authors declare that they have no competing interest.

Ethical Approval

All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed Consent

As this was a retrospective study, no formal consent was acquired.

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Authors and Affiliations

  1. Department of Bariatric Surgery, Gem Hospital, Coimbatore, Tamil Nadu, India

    Palanivelu Praveenraj, Rachel Maria Gomes & Saravana Kumar

  2. Department of Surgical Gastroenterology, GEM Hospital and Research Centre, Coimbatore, Tamil Nadu, India

    Palanisamy Senthilnathan, Ramakrishnan Parthasarathi, Subbiah Rajapandian & Chinnusamy Palanivelu

Authors
  1. Palanivelu Praveenraj
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  2. Rachel Maria Gomes
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  3. Saravana Kumar
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  4. Palanisamy Senthilnathan
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  5. Ramakrishnan Parthasarathi
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  6. Subbiah Rajapandian
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  7. Chinnusamy Palanivelu
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Corresponding author

Correspondence to Palanivelu Praveenraj.

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Praveenraj, P., Gomes, R.M., Kumar, S. et al. Concomitant Bariatric Surgery with Laparoscopic Intra-peritoneal Onlay Mesh Repair for Recurrent Ventral Hernias in Morbidly Obese Patients: an Evolving Standard of Care. OBES SURG 26, 1191–1194 (2016). https://doi.org/10.1007/s11695-015-1875-4

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  • DOI: https://doi.org/10.1007/s11695-015-1875-4

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