title: Outcomes of concomitant ventral hernia repair performed during bariatric surgery.
abstract: Currently there is no consensus on management of ventral hernias encountered during bariatric surgery (BS). This study aims to evaluate the incidence and outcomes of concomitant ventral hernia repair (VHR) during BS at our institution.
  
  
  
  Patients who had concomitant VHR during BS from 2004 to 2015 were identified. Data collected included baseline demographics, comorbidities, perioperative parameters, surgical approach and postoperative outcomes.
  
  
  
  A total of 159 patients underwent concomitant VHR during the study period at the time of BS. One hundred and one (64 %) patients were female; median age was 53 years (IQR 45.0-60.3) and median BMI was 48.2 kg/m2(IQR 41.6-54.1). Comorbidities included: hypertension (n = 124, 78 %), type 2 diabetes (n = 103, 65 %), hyperlipidemia (n = 100, 63 %), obstructive sleep apnea (n = 98, 62 %) and reflux disease (n = 54, 34 %). Out of 159 patients, 41 patients (26 %) had a prior VHR. Out of 103 patients, 69 patients (67 %) had a previous abdominal surgery. Of the concomitant VHR, 144 (91 %) were completed laparoscopically, 12 (7 %) patients were converted to open surgery and 3 (2 %) patients underwent primary open procedures. Technique included primary suture closure in 115 (72 %) and mesh repair in 44. Early postoperative complications (<30 days) were reported in 16 (10 %) patients, with superficial wound infection (n = 9), bowel obstruction (n = 2), marginal ulcer (n = 2), DVT (n = 1) and pneumonia (n = 1). Hernia recurrence was reported in 3 patients (2 %) in the early post-op period and in 40 patients (25 %) as a late (>30 days) complication. Surgery for recurrent hernia was performed in 31/42 patients during follow-up. At 12-month follow-up, median BMI and % excess weight loss were 34.2 kg/m2(IQR 29.5-40.9) and 59.6 % (IQR 44.9-74.8 %), respectively.
  
  
  
  Ventral hernia is a common finding in patients undergoing BS. Both primary suture repair and mesh repair result in acceptable results, both in terms of recurrence and perioperative complications.
authors: Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave/A100, Cleveland, OH, 44195, USA. sharmag@ccf.org.
authors: G
authors: 0000-0003-1512-640X
authors: G
authors: Sharma
authors: Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave/A100, Cleveland, OH, 44195, USA.
authors: M
authors: M
authors: Boules
authors: Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave/A100, Cleveland, OH, 44195, USA.
authors: S
authors: S
authors: Punchai
authors: Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave/A100, Cleveland, OH, 44195, USA.
authors: A
authors: A
authors: Strong
authors: Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave/A100, Cleveland, OH, 44195, USA.
authors: D
authors: D
authors: Froylich
authors: Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave/A100, Cleveland, OH, 44195, USA.
authors: N H
authors: NH
authors: Zubaidah
authors: Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave/A100, Cleveland, OH, 44195, USA.
authors: C
authors: C
authors: O'Rourke
authors: Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave/A100, Cleveland, OH, 44195, USA.
authors: S A
authors: SA
authors: Brethauer
authors: Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave/A100, Cleveland, OH, 44195, USA.
authors: J
authors: J
authors: Rodriguez
authors: Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave/A100, Cleveland, OH, 44195, USA.
authors: K
authors: K
authors: El-Hayek
authors: Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave/A100, Cleveland, OH, 44195, USA.
authors: M
authors: M
authors: Kroh
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods; D015897:Comorbidity; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D013537:Sutures; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Bariatric surgery; Concomitant; Laparoscopic; Outcomes; Roux-en-Y gastric bypass; Ventral hernia repair