Management of Ventral Hernia in Obese Patients: Before or After Bariatric Surgery?

Abstract

Obesity is a known risk factor for ventral hernias and their recurrences. The timing of ventral hernia repair in obese patients who are candidates for bariatric surgery is still a debatable topic. To this date, there is no consensus, neither for the timing nor for the surgical repair technic. In this chapter, we will review briefly what was already discussed about this dilemma and explore our experience with our retrospective study. If asymptomatic, the ventral hernia should be repaired after bariatric surgery when there is stabilization of the weight loss. Laparoscopic approach is recommended to allow an exploration of the trocars sites and a second look after obesity surgery. An algorithm for ventral hernia management in obese patients is proposed.

Innovative Approaches to Address the Technical Challenge of Hernial Sac Distension Due to Pneumoperitoneum in the Synchronous Management of Complex Hernias in Individuals With Morbid Obesity

“…Existing literature predominantly indicates slightly lower recurrence rates in laparoscopic repair, although this association has not always reached statistical significance. Despite its advantages, laparoscopy is not without drawbacks, including a heightened risk of visceral injury and increased technical difficulty due to the compromised intraperitoneal space [22].…”