Management of patients with hernia or incisional hernia undergoing surgery for morbid obesity

Area of Science:

• Bariatric Surgery
• Abdominal Wall Reconstruction
• Hernia Surgery

Background:

• Morbidly obese patients (MOPs) have a higher risk of abdominal wall hernias.
• Complications include small bowel obstruction and increased morbidity.
• Incisional hernias are a concern after weight loss surgery.

Purpose of the Study:

• To review the surgical management of abdominal wall hernias in MOPs.
• To discuss strategies for hernia prophylaxis during bariatric procedures.
• To explore the controversy surrounding the timing and methods of hernia repair.

Main Methods:

• Review of surgical experiences in treating MOPs with abdominal wall hernias.
• Discussion of hernia repair techniques, including simultaneous repair or delayed repair.
• Consideration of techniques like omental splits and plug placement.

Main Results:

• Hernia prophylaxis is explored as a method to reduce incisional hernia risk.
• The study emphasizes the debate on optimal repair timing and surgical approach.
• Specific techniques for managing the hernia defect during gastric bypass are highlighted.

Conclusions:

• Optimal timing and method for abdominal wall hernia repair in MOPs undergoing gastric bypass remain debated.
• Surgical strategies aim to mitigate risks of hernia complications and incisional hernias.
• Delayed repair may be considered in conjunction with specific surgical techniques.