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

Autor: Eid, G. M., Mattar, S. G., Hamad, G., Cottam, D. R., Lord, J. L., Watson, A., Dallal, M., Schauer, P. R.
Zdroj: Surgical Endoscopy; February 2004, Vol. 18 Issue: 2 p207-210, 4p
Abstrakt: 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.
Databáze: Supplemental Index