Concurrent Laparoscopic Ventral Hernia Repair with Bariatric Surgery: a Propensity-Matched Analysis

Area of Science:

• Bariatric Surgery
• Surgical Outcomes
• Hernia Repair

Background:

• Ventral hernias are common in bariatric surgery patients.
• The risks and benefits of concurrent ventral hernia repair (VHR) during bariatric surgery are not well-defined.
• This study analyzes short-term outcomes of concurrent VHR during bariatric procedures.

Purpose of the Study:

• To evaluate the short-term outcomes of bariatric surgery with concurrent ventral hernia repair (VHR) versus bariatric surgery alone.
• To compare major complication rates, operative time, length of stay, readmission, and mortality between the two groups.
• To identify specific risks associated with concurrent VHR in different bariatric procedures.

Main Methods:

• Utilized the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database.
• Included patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG).
• Performed a one-to-one propensity score-matched analysis comparing concurrent VHR with bariatric surgery alone.

Main Results:

• Concurrent VHR was associated with a higher 30-day major complication rate (5.8% vs. 3.8%, p < 0.001).
• No significant difference in 30-day mortality was observed (0.3% vs. 0.2%, p = 0.531).
• Both LSG with VHR and RYGB with VHR showed increased major complications compared to surgery alone.

Conclusions:

• Concurrent VHR during bariatric surgery is linked to increased major complications, especially with LRYGB.
• Mortality rates are not significantly different between concurrent VHR and bariatric surgery alone.
• Surgeons must carefully consider the elevated complication risks when performing VHR during bariatric surgery.