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01.02.2004 | Original article | Ausgabe 2/2004

Surgical Endoscopy 2/2004

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

Zeitschrift:
Surgical Endoscopy > Ausgabe 2/2004
Autoren:
G. M. Eid, S. G. Mattar, G. Hamad, D. R. Cottam, J. L. Lord, A. Watson, M. Dallal, P. R. Schauer
Wichtige Hinweise
Presented at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES), Los Angeles, CA, USA, 10–15 March 2003

Abstract

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.

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