BACKGROUND: Obesity is an important risk factor for perioperative complications including the development of ventral hernias. METHODS: This retrospective study comprises patients who underwent abdominal hernia repair simultaneously with or following implantation of a Swedish Adjustable Gastric Band(R) (SAGB). RESULTS: 9 out of 415 patients (2.2%) who received a SAGB between January 1996 and June 2001 underwent ventral hernia repair. In 6 patients, hernias preexisted from previous abdominal surgery at the time of the bariatric procedure, and another 3 hernias occurred at the median and left upper abdominal trocar position following SAGB placement. Median BMI at time of SAGB implantation was 44 (range 35-52), and at time of hernia repair was 36 (range 25-46). 2 hernias were repaired during SAGB placement, 3 during redo surgery, and 2 during abdominoplasty. In 2 patients, significant weight loss with loss of soft tissue support of the hernia sac led to recurrent episodes of small bowel obstruction necessitating emergency repair. Repair included direct defect closure in 7 patients and sublay polypropylene net implantation in 2 patients. Recoveries have been uneventful without wound infections or recurrence in all patients after a median follow-up of 34 months (range 13-69). CONCLUSION: In morbidly obese patients, the optimal management and timing of incisional hernia repair should weigh the risk of recurrence and perioperative complications against the risk of hernia-associated complications.
BACKGROUND: Obesity is an important risk factor for perioperative complications including the development of ventral hernias. METHODS: This retrospective study comprises patients who underwent abdominal hernia repair simultaneously with or following implantation of a Swedish Adjustable Gastric Band(R) (SAGB). RESULTS: 9 out of 415 patients (2.2%) who received a SAGB between January 1996 and June 2001 underwent ventral hernia repair. In 6 patients, hernias preexisted from previous abdominal surgery at the time of the bariatric procedure, and another 3 hernias occurred at the median and left upper abdominal trocar position following SAGB placement. Median BMI at time of SAGB implantation was 44 (range 35-52), and at time of hernia repair was 36 (range 25-46). 2 hernias were repaired during SAGB placement, 3 during redo surgery, and 2 during abdominoplasty. In 2 patients, significant weight loss with loss of soft tissue support of the hernia sac led to recurrent episodes of small bowel obstruction necessitating emergency repair. Repair included direct defect closure in 7 patients and sublay polypropylene net implantation in 2 patients. Recoveries have been uneventful without wound infections or recurrence in all patients after a median follow-up of 34 months (range 13-69). CONCLUSION: In morbidly obesepatients, the optimal management and timing of incisional hernia repair should weigh the risk of recurrence and perioperative complications against the risk of hernia-associated complications.
Authors: Konstantinos Spaniolas; Kevin R Kasten; Anthony B Mozer; Megan E Sippey; William H H Chapman; Walter J Pories; John R Pender Journal: Obes Surg Date: 2015-10 Impact factor: 4.129
Authors: P Praveen Raj; P Senthilnathan; R Kumaravel; S Rajpandian; P S Rajan; N Anand Vijay; C Palanivelu Journal: Obes Surg Date: 2012-05 Impact factor: 4.129
Authors: 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 Journal: Surg Endosc Date: 2016-08-05 Impact factor: 4.584
Authors: W L Newcomb; J L Polhill; A Y Chen; T S Kuwada; K S Gersin; S B Getz; K W Kercher; B T Heniford Journal: Hernia Date: 2008-05-21 Impact factor: 4.739