Obesity and Ventral Hernia Repair: Is There Success in Staging?

2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Indications for Metabolic and Bariatric Surgery

“…Obesity is a risk factor for the development of ventral hernia. It increases the risk for impaired wound healing, local and systemic infections, and other complications following hernia repair, and increases the risk for recurrence [74][75][76]. In addition to a larger volume of subcutaneous soft tissue, abdominal wall hernias in the population with obesity tend to be larger, adding to the complexity of repair in these patients.…”

“…In addition to a larger volume of subcutaneous soft tissue, abdominal wall hernias in the population with obesity tend to be larger, adding to the complexity of repair in these patients. While the timing of MBS relative to hernia repair remains controversial, evidence suggests that patients with large, chronic abdominal wall hernia may benefit from significant weight loss initially as staged procedure to definitive hernia repair [ 75 , 77 ]. Thus, in patients with severe obesity and an abdominal wall hernia requiring elective repair, MBS should be considered first to induce significant weight loss, and consequently reduce the rate of complications associated with hernia repair and increase durability of the repair.…”

The way to a man’s heart is through his stomach? A unique case report of transient constrictive pericarditis secondary to infarction of herniated omentum following bariatric surgery

“…However, in clinical practice incidental hernias are often best managed after weight loss is achieved. 14 Chest imaging (even CXR) pre bariatric surgery would have been informative in this case. It would have revealed an abnormal cardiac silhouette and triggered further investigations including echocardiography and CT.…”

Medial incisional ventral hernia repair with Adhesix® autoadhesive mesh: descriptive study

“…However, studies agree that the use of low weight mesh is preferable due to its low incidence of postoperative pain, considering that in the degradation procedure, this type of mesh leaves less prosthetic material without increasing the risk of recurrences [ 4 , 19 , 24 ]. Although there is no evidence that this surgical detail improves patients’ quality of life in incisional hernia surgery, most data point to a benefit being found in inguinal hernia surgery [ 25 ]. Besides, it is widely known that the most important factor to reduce the recurrence rate is the correct placement of the mesh in the first surgery [ 26 ], due to most of recurrences occurring in the caudal region.…”