title: Simultaneous ventral hernia repair in bariatric surgery.
abstract: BACKGROUND
  Obesity is a significant risk factor in abdominal hernia occurrence and recurrence. In patients having bariatric surgery, there are no clear guidelines as to whether repair should be done simultaneously, especially if procedures involve division or resection of part of the gastrointestinal tract.
  
  
  METHODS
  A retrospective case series review over a 6-year period to December 2012 from a prospective database was conducted. As per existing practice for bariatric procedures, patients were followed up indefinitely. Short- and long-term outcomes were analysed.
  
  
  RESULTS
  Forty-five patients underwent combined laparoscopic bariatric surgery and abdominal wall hernia repair. Of these, 36 had resection procedures (gastric bypass or sleeve gastrectomy) and 9 had non-resection procedures (gastric banding). The mean operative time was 151 min and the mean length of stay was 3 days. Two patients developed post-operative mesh seroma infections. To date, there have been no mesh removals or recurrent hernias. There was no mortality in this series.
  
  
  CONCLUSIONS
  This study demonstrated a low rate of mesh infection (4.44%) at a median follow-up of 13 months, even when a resectional procedure was performed (5.56%). These results suggest the possible viability and reasonable short-/long-term outcomes of simultaneous laparoscopic abdominal wall hernia repair during bariatric surgical procedures, even if the surgery involved division or resection of part of the gastrointestinal tract. This topic is an area of clinical research that warrants further study.
authors: Upper Gastrointestinal Surgery Unit, St George Hospital, Sydney, New South Wales, Australia; UNSW Department of Surgery, St George Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
authors: Daniel Leonard
authors: DL
authors: Chan
authors: Michael Leonard
authors: ML
authors: Talbot
authors: Zhuoran
authors: Z
authors: Chen
authors: Sebastianus Chang Mo
authors: SC
authors: Kwon
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy; D006555:Hernia, Ventral / Q000150:complications / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D061646:Operative Time; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome
keywords: bariatric surgery; hernia repair; laparoscopic; upper gastrointestinal