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Prophylactic mesh to prevent incisional hernia: a note of caution
Garth S Herbert1, Timothy J Tausch, Preston L Carter
1Department of Surgery, Madigan Army Medical Center, Ft Lewis, WA, USA. garth_herbert@hotmail.com
American Journal of Surgery
|March 25, 2009
Summary
Prophylactic mesh placement during open Roux-en-Y gastric bypass (RYGB) resulted in a high rate of complications. This technique is not recommended due to unacceptable local issues in patients undergoing open RYGB.
Area of Science:
- Bariatric surgery
- Surgical complications
- Hernia repair
Background:
- Ventral hernias are a frequent complication following open Roux-en-Y gastric bypass (RYGB).
- Assessing the efficacy of prophylactic mesh in preventing these hernias is crucial.
Purpose of the Study:
- To evaluate if prophylactic mesh placement during open RYGB reduces the incidence of postoperative ventral hernias.
- To assess the morbidity associated with mesh placement in this context.
Main Methods:
- Obese patients undergoing open RYGB had subfascial prosthetic mesh placed.
- Follow-up assessed hernia recurrence and mesh-related complications.
Main Results:
- 25% of patients required mesh excision due to infection or symptomatic seroma.
- One patient developed an incisional hernia despite prophylactic mesh.
- A significant complication rate was observed within a 6-month follow-up period.
Conclusions:
- Prophylactic mesh use in open RYGB is associated with an unacceptable rate of local complications.
- The study advises against using this technique in patients undergoing open RYGB.
- High complication rates suggest mesh placement may not be beneficial for hernia prevention in this specific surgical approach.
