Chandru P. Sundaram

School of Medicine, Urology

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

G.M. Eid; S.G. Mattar; G. Hamad; D.R. Cottam; J.L. Lord; A. Watson; R.M. Dallal; P.R. Schauer (Profiled Author: Samer G. Mattar)

Surgical Endoscopy and Other Interventional Techniques. 2004;18(2):207-210.

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.

PMID: 14691700    

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