Skip to main content
SpringerLink
Log in

Concomitant Ventral Hernia Repair and Bariatric Surgery: a Systematic Review

  • Review
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

This study is a review on the management of ventral hernia during bariatric surgery. The main outcomes are the recurrence rate after ventral hernia repair and the incidence of prosthetic infection. Eleven studies were included. Ventral hernias were treated by simple suture (n = 191), synthetic mesh (n = 186), and biological mesh (n = 72). Mean defect size was 18 cm2. Recurrence rate was 25.7% in the suture group, 14.3% in the biomesh group, and 1.1% in the synthetic mesh group (p < 0.05). Mesh infection rate was not different between the groups. No significant difference was observed in 30-day reoperation. Concomitant treatment of small hernia defect is feasible and safe during bariatric surgery. Synthetic mesh provides a significantly lower recurrence rate without any increase in 30-day wound morbidity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Sugerman HJ, Kellum Jr JM, Reines HD, et al. Greater risk of incisional hernia with morbidly obese than steroid-dependent patients and low recurrence with prefascial polypropylene mesh. Am J Surg. 1996;171(1):80–4.

    Article  CAS  Google Scholar 

  2. Liang MK, Holihan JL, Itani K, et al. Ventral hernia management: expert consensus guided by systematic review. Ann Surg. 2017;265(1):80–9.

    Article  Google Scholar 

  3. Heniford BT, Park A, Ramshaw B, et al. Laparoscopic repair of ventral hernias nine years’ experience with 850 consecutive hernias. Ann Surg. 2003;238:391–400.

    Google Scholar 

  4. 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. 2004;18:207–10.

    Article  CAS  Google Scholar 

  5. Borud L, Grunwaldt L, Janz B, et al. Components separation combined with abdominal wall plication for repair of large abdominal wall hernias following bariatric surgery. Plast Reconstr Surg. 2007;119:1792–8.

    Article  CAS  Google Scholar 

  6. Newcomb WL, Polhill JL, Chen AY, et al. Staged hernia repair preceded by gastric bypass for the treatment of morbidly obese patients with complex ventral hernias. Hernia. 2008;12:465–9.

    Article  CAS  Google Scholar 

  7. Borbély Y, Zerkowski J, Altmeier J, et al. Complex hernias with loss of domain in morbidly obese patients: role of laparoscopic sleeve gastrectomy in a multi-step approach. Surg Obes Relat Dis. 2017;13:768–3.

    Article  Google Scholar 

  8. Lee L, Mata J, Landry T, et al. A systematic review of synthetic and biologic materials for abdominal wall reinforcement in contaminated fields. Surg Endosc. 2014;28(9):2531–46.

    Article  Google Scholar 

  9. Rao RS, Gentileschi P, Kini SU. Management of ventral hernias in bariatric surgery. Surg Obes Relat Dis. 2011;7(1):110–6.

    Article  Google Scholar 

  10. Sait MS, Som R, Borg CM, et al. Best evidence topic: should ventral hernia repair be performed at the same time as bariatric surgery? Ann Med Surg. 2016;11:21–5.

    Article  Google Scholar 

  11. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6:e1000100.

    Article  Google Scholar 

  12. Slim K, Nini E, Forestier D, et al. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73:712–6.

    Article  Google Scholar 

  13. Cox DR. The continuity correction. Biometrika. 1970;57(1):217–9.

    Article  Google Scholar 

  14. Bonatti H, Hoeller E, Kirchmayr W, et al. Ventral hernia repair in bariatric surgery. Obes Surg. 2004;14:655–8.

    Article  Google Scholar 

  15. Schuster R, Curet MJ, Alami RS, et al. Concurrent gastric bypass and repair of anterior abdominal wall hernias. Obes Surg. 2006;16:1205–8.

    Article  Google Scholar 

  16. Datta T, Eid G, Nahmias N, et al. Management of ventral hernias during laparoscopic gastric bypass. Surgery Obes Relat Dis. 2008;4:754–8.

    Article  Google Scholar 

  17. Praveenraj P, Senthilnathan P, Kumaravel R, et al. Concomitant laparoscopic ventral hernia mesh repair and bariatric surgery: a retrospective study from a tertiary care center. Obes Surg. 2012;22:685–9.

    Article  CAS  Google Scholar 

  18. Eid GM, Wikiel KJ, Entabi F, et al. Ventral hernias in morbidly obese patients: a suggested algorithm for operative repair. Obes Surg. 2013;23:703–9.

    Article  Google Scholar 

  19. Chan DL, Talbot ML, Chen Z, et al. Simultaneous ventral hernia repair in bariatric surgery. ANZ J Surg. 2014;84:581–3.

    Article  Google Scholar 

  20. Raziel A, Sakran N, Szold A, et al. Concomitant bariatric and ventral/incisional hernia surgery in morbidly obese patients. Surg Endosc. 2014;28:1209–12.

    Article  Google Scholar 

  21. Praveenraj P, Gomes RM, 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. 2016;26:1191–4.

    Article  Google Scholar 

  22. Sharma G, Boules M, Punchai S, et al. Outcomes of concomitant ventral hernia repair performed during bariatric surgery. Surg Endosc. 2017;31:1573–82.

    Article  CAS  Google Scholar 

  23. Birindelli A, Sartelli M, Saverio D, et al. 2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias. World J Emerg Surg. 2017;12:37.

    Article  Google Scholar 

  24. Sauerland S, Walgenbach M, Habermalz B, et al. Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev. 2011;(3):CD007781.

  25. Cozacov Y, Szomstein S, Safdie FM, et al. Is the use of prosthetic mesh recommended in severely obese patients undergoing concomitant abdominal wall hernia repair and sleeve gastrectomy? J Am Coll Surg. 2014;218:358–62.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General Surgery, Centre Hospitalier Intercommunal de Créteil, 40 Avenue de Verdun, 94000, Créteil, France

    Andrea Lazzati, Georges Bou Nassif & Luca Paolino

  2. INSERM, UMR_S 1138, Centre de Recherche des Cordeliers, Université Paris Descartes, 75006, Paris, France

    Andrea Lazzati

Authors
  1. Andrea Lazzati
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Georges Bou Nassif
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Luca Paolino
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrea Lazzati.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Statement on Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Disclosures

Dr. Andrea Lazzati did not receive any payment or services from a third party (government, commercial, private foundation, etc.) for any aspect of the submitted work (including but not limited to grants, data monitoring board, study design, manuscript preparation, statistical analysis, etc.). Dr. Georges Bou Nassif, co-author, did not receive any payment or services from a third party (government, commercial, private foundation, etc.) for any aspect of the submitted work (including but not limited to grants, data monitoring board, study design, manuscript preparation, statistical analysis, etc.). Dr. Luca Paolino did not receive any payment or services from a third party (government, commercial, private foundation, etc.) for any aspect of the submitted work (including but not limited to grants, data monitoring board, study design, manuscript preparation, statistical analysis, etc.). Dr. Andrea Lazzati, corresponding author of this study, certify that the manuscript did not involve the use of animal or human subjects.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lazzati, A., Nassif, G.B. & Paolino, L. Concomitant Ventral Hernia Repair and Bariatric Surgery: a Systematic Review. OBES SURG 28, 2949–2955 (2018). https://doi.org/10.1007/s11695-018-3366-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-018-3366-x

Keywords

Search

Navigation