Simultaneous panniculectomy and ventral hernia repair following weight reduction after gastric bypass surgery: is it safe?

BACKGROUND: Successful obesity surgery often results months later in redundant abdominal skin and subcutaneous tissue. Following open obesity surgery, ventral hernias are also common, yet little has been written about the safety of combining panniculectomy with ventral hernia repair. We performed a retrospective analysis of a single plastic surgeon's experience with panniculectomy following gastric bypass surgery including both patients undergoing and those not undergoing simultaneous ventral hernia repair.
METHODS: We reviewed the hospital and office records of patients undergoing panniculectomy at two university-affiliated community hospitals from March 2002 to February 2005 following gastric bypass surgery.
RESULTS: The records of 100 patients (91 women) were available for review. Median age was 48 (range 25-65) and median interval between bypass surgery and panniculectomy was 23 months (range 6-286). Median decrease in BMI was 19 (range 13-47). Eighty-three patients underwent panniculectomy combined with at least one other procedure, most commonly ventral hernia repair (70) and buttock lift (9). Forty hernia repairs were performed with mesh. No patient required mesh removal in the postoperative period. Median length of hospital stay was 3 days (range 1-7). Twenty-nine patients required outpatient sharp debridement. Ten patients were readmitted for management of wound complications. No patients sustained a stroke, myocardial infarction, or pulmonary embolus. There was no mortality.
CONCLUSIONS: Following obesity surgery, simultaneous ventral hernia repair and panniculectomy can be accomplished safely with short hospital stays and few in-hospital complications. Postoperative wound problems are not infrequent but can be managed in the outpatient setting.