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Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
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Bariatric Surgery: Bridge for Ventral Hernia Repair?

Justin L Hsu1, Kelsey R Landrum2,3, Maggie M Hodges3

  • 1Department of Surgery, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.

The American Surgeon
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Summary

Patients who underwent bariatric surgery had a higher risk of hernia reoperation after ventral hernia repair (VHR). This suggests bariatric surgery may impact VHR outcomes beyond weight loss alone.

Keywords:
MarketScanbariatric surgeryherniaobesityweight loss

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Area of Science:

  • Surgical outcomes
  • Bariatric surgery
  • Hernia repair

Background:

  • Obesity is a known risk factor for complications and recurrence in ventral hernia repair (VHR).
  • The specific impact of prior bariatric surgery on VHR outcomes remains under-investigated.
  • This study examines elective VHR in patients with and without a history of bariatric surgery.

Purpose of the Study:

  • To evaluate the outcomes of elective ventral hernia repair (VHR) in patients with a history of bariatric surgery.
  • To compare postoperative complications and reoperation rates between obese patients with and without prior bariatric procedures.

Main Methods:

  • Retrospective analysis of the IBM MarketScan® database (2000-2021).
  • Inclusion of elective VHR patients: bariatric group vs. obese control group.
  • Propensity score weighting to balance confounders; comparison of 30-day complications and 1, 3, 5-year reoperations.

Main Results:

  • 10,468 patients included; 55.9% of the bariatric group remained obese at VHR.
  • Bariatric group had lower comorbidity index but more concurrent operations.
  • Higher incidence of hematoma/seroma drainage (3.7% vs 2.3%) and hernia reoperation (1, 3, 5 years: 7.8% vs 5.5%, 12.9% vs 9.9%, 14.7% vs 11%) in the bariatric group.

Conclusions:

  • Patients with prior bariatric surgery demonstrated an increased risk of hernia reoperation after VHR.
  • Weight loss from bariatric surgery may mitigate some VHR risks.
  • Additional factors related to bariatric surgery and weight loss require careful consideration for VHR outcomes.