Outcomes of Open Retro-Rectus Hernia Repair With Mesh in Obesity Class III.
Outcomes of Open Retro-Rectus Hernia Repair With Mesh in Obesity Class III. Am Surg. 2020 Sep 24;:3134820945246 Authors: Martinez M, Dove J, Blansfield J, Widom K, Semian J, Alaparthi M, Factor M 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, 2018, were collected and retrospectively analyzed. RESULTS: Cohorts were composed of 2 groups, BMI ≥ 40 kg/m2 (n = 117) and BMI
This study reviews treatment recommendations and patient compliance at a multi-surgeon bariatric clinic.
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 (
Hiatal hernias are often repaired concurrently with bariatric surgery to reduce risk of GERD-related complications.
ConclusionsIn this study, staged mesh repair of complex abdominal wall hernias after bariatric surgery in morbidly obese patients was associated with acceptable morbidity and no hernia recurrences at approximately 1.5 year follow-up.
In the paper by Angrisani et al. , the authors tackle an important question, namely, what are the long-term outcomes regarding gastroesophageal reflux disease (GERD) in patients undergoing sleeve gastrectomy (SG)? Many surgeons consider GERD to be the Achilles’ heel of the SG, and it is one of the main reasons for conver sion of the SG to other procedures, such as the gastric bypass . The last International Consensus Conference on SG demonstrated>50% of surgeons considered GERD to be a relative contraindication to the SG, and also hiatal hernias (HH) should be repaired when encountered .
In the paper by Angrisani et al, the authors tackle an important question, namely; what are the long term outcomes regarding gastroesophageal reflux disease (GERD) in patients undergoing sleeve gastrectomy (SG) ? Many surgeons consider GERD to be the Achilles heel of the SG, and it is one of the main reasons for conversion of the SG to other procedures such as the gastric bypass . The last International Consensus Conference on SG demonstrated that over 50% of surgeons considered GERD to be a relative contrindication to the SG, and also that hiatal hernias (HH) should be repaired when encountered .
ConclusionA tailored approach is now employed and seen more so in hernia surgery and this fact is referred to and highlighted in the contemporaneous hernia guidelines published to date. In addition, with the increasing complexity of abdominal wall surgery, the number of procedures actually performed by trainees is no longer considered adequate to overcome any recognized learning curve. Therefore, to supplement general surgery training young surgeons should be offered a clinical fellowship to obtain an additional qualification as an abdominal wall surgeon and thus improve their clinical and operative experience under superv...
Gastroesophageal reflux disease (GERD) is common in the morbidly obese population, and hiatal hernias are encountered in 20% to 52% of patients. Primary surgical repair of hiatal hernias, in particular the paraesophageal type, is associated with a higher recurrence rate in obese patients. Concomitant weight loss surgery may be advisable. Combined sleeve gastrectomy and paraesophageal hiatal hernia repair is feasible but can induce or worsen preexisting GERD. A Roux-en-Y gastric bypass offers advantages of more pronounced excess weight loss and better symptom control, albeit with a potentially higher rate of morbidity compa...
Paraesophageal hernias (PEH) are common among patients with obesity. Most patients with severe obesity and a PEH will have the PEH repaired at the time of bariatric surgery. However, it is unclear whether there is increased risk when repairing a PEH during bariatric surgery.