A620 Laparoscopic Hiatal Hernia Repair after Initial Failure of Repair at the Time of Sleeve Gastrectomy
38-year-old female with no symptomatic reflux who underwent a sleeve gastrectomy for morbid obesity. At the time of surgery, she was found to have an approximately 5 cm hiatal hernia, which was repaired posteriorly. Post-operatively, she developed significant nausea and vomiting. Upper GI study and CT scan demonstrated a failure of the hiatal hernia repair with a significant portion of the stomach in the chest. She was taken back to the operating room for repair.
Authors: Boru CE, Termine P, Antypas P, Iossa A, Ciccioriccio MC, De Angelis F, Micalizzi A, Silecchia G Abstract BACKGROUND: Hiatal hernia repair (HHR) is still controversial during bariatric procedures, especially in case of laparoscopic sleeve gastrectomy (LSG). AIMS: to report the long-term results of concomitant HHR, evaluating the safety and efficacy of posterior cruroplasty (PC), simple or reinforced with biosynthetic, absorbable Bio-A® mesh (Gore, USA). Primary endpoint: PC's failure, defined as symptomatic HH recurrence, nonresponding to medical treatment and requiring revisional surgery. METHO...
This study aims to report our experience in LHHR without mesh and compare the short-term outcomes between non-obese (BMI
This study reviews treatment recommendations and patient compliance at a multi-surgeon bariatric clinic.
Abstract BACKGROUND: Abdominal wall hernias continue to be one of the most common general surgery pathologies. Patients with an elevated body mass index (BMI) are routinely counseled about weight loss before elective repair. However, a definitive BMI "cutoff" has not been established. Here, we report our experience with open retro-rectus hernia repair (ORRHR) with mesh in patients with a BMI over 40 kg/m2, and we attempt to determine if a BMI "cutoff" can be established. METHODS: Data from patients undergoing ORRHR with mesh at Geisinger Medical Center from January 1, 2014, to December 31,...
This study was a retrospective review of a prospectively maintained hernia registry from the 1st of February 2019 to 29th of February 2020.Results353 ventral hernia repair cases were recorded of which 47% were incisional hernias and the remainder were primary hernias. The median age was 54 years with even distribution of males and females. Half of the patients were obese with a median BMI of 31 kg/m2. The private sector performed 190 cases (54%) and the public sector 163 cases (46%). The public sector had more current smokers undergoing elective repairs, 28% vs 15%,p = 0.01 and performed more emerg...
AbstractIntroductionHow best to treat a small (
CONCLUSIONS: Obesity was a prevalent comorbidity in the patient population we reviewed. Given the role obesity plays in abdominal and hiatal hernia repair success rates, it should be considered that obesity is a significant contributor to chest wall herniation if rib fractures occur. With 66% chest wall repair failure, patient selection is critical in the success of surgical intervention. Perhaps additional patient optimization, especially weight loss, should be considered prior to surgery. PMID: 32927964 [PubMed - as supplied by publisher]
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Hiatal hernias are often repaired concurrently with bariatric surgery to reduce risk of GERD-related complications.