BACKGROUND: Ventral hernia is a common complication of open Roux-en-Y gastric bypass (RYGB). The aim of this study was to determine whether prophylactic mesh placement during RYGB would reduce the incidence of postoperative hernias. METHODS: Obese patients undergoing RYGB by a single surgeon had prosthetic mesh placed in a subfascial location at the conclusion of the procedure. The incidences of recurrent hernia and morbidity associated with the placement of mesh were assessed. RESULTS: Sixteen patients underwent RYGB with prophylactic mesh placement over 6 months. The average preoperative body mass index was 46.6 kg/m(2). Half of the patients were diabetics. None were smokers. During mean follow-up of 6 months, 4 patients (25%) required mesh excision, 3 for infection and 1 for a persistently symptomatic seroma. One patient was explanted incidentally in the course of reexploration for intractable nausea and vomiting. Another developed an incisional hernia despite prophylactic mesh. CONCLUSIONS: In the investigators' experience, the use of prophylactic new-generation mesh at the time of open RYGB led to an unacceptable rate of local complications. They caution against this technique in patients undergoing open RYGB.
BACKGROUND:Ventral hernia is a common complication of open Roux-en-Y gastric bypass (RYGB). The aim of this study was to determine whether prophylactic mesh placement during RYGB would reduce the incidence of postoperative hernias. METHODS: Obese patients undergoing RYGB by a single surgeon had prosthetic mesh placed in a subfascial location at the conclusion of the procedure. The incidences of recurrent hernia and morbidity associated with the placement of mesh were assessed. RESULTS: Sixteen patients underwent RYGB with prophylactic mesh placement over 6 months. The average preoperative body mass index was 46.6 kg/m(2). Half of the patients were diabetics. None were smokers. During mean follow-up of 6 months, 4 patients (25%) required mesh excision, 3 for infection and 1 for a persistently symptomatic seroma. One patient was explanted incidentally in the course of reexploration for intractable nausea and vomiting. Another developed an incisional hernia despite prophylactic mesh. CONCLUSIONS: In the investigators' experience, the use of prophylactic new-generation mesh at the time of open RYGB led to an unacceptable rate of local complications. They caution against this technique in patients undergoing open RYGB.
Authors: David Earle; J Scott Roth; Alan Saber; Steve Haggerty; Joel F Bradley; Robert Fanelli; Raymond Price; William S Richardson; Dimitrios Stefanidis Journal: Surg Endosc Date: 2016-07-12 Impact factor: 4.584
Authors: Lawrence Lee; Juan Mata; Tara Landry; Kosar A Khwaja; Melina C Vassiliou; Gerald M Fried; Liane S Feldman Journal: Surg Endosc Date: 2014-03-12 Impact factor: 4.584
Authors: A Bravo-Salva; A M González-Castillo; F F Vela-Polanco; E Membrilla-Fernández; J Vila-Domenech; M Pera-Román; J J Sancho-Insenser; J A Pereira-Rodríguez Journal: World J Surg Date: 2020-03 Impact factor: 3.352
Authors: C Bali; J Papakostas; G Georgiou; G Kouvelos; S Avgos; E Arnaoutoglou; G Papadopoulos; M Matsagkas Journal: Hernia Date: 2014-05-13 Impact factor: 4.739