Background: Ventral hernia is common in obese individuals. Obesity causes an increase in intra-abdominal pressure and poor wound healing, which results in the development of a ventral hernia. The treatment of hernia in obese individuals is a matter of debate, especially in patients undergoing bariatric surgery. Different modalities of treatment have been proposed by different authors for the management of ventral hernia in patients who are candidates for bariatric surgery. We aim to find a feasible option for the simultaneous treatment of obesity and hernia with minimum complications at an affordable cost.
Methods: A retrospective analysis of 41 patients who underwent bariatric surgery and open pre-peritoneal mesh repair of ventral hernia at ILS Hospital, Kolkata, between 2009 – 2017 was done, and the results were analyzed based on demographic characters, intra-operative findings, and post-operative parameters. Patients underwent two types of bariatric procedure viz. Laparoscopic Sleeve Gastrectomy (LSG) and Mini Gastric Bypass (MGB).
Results: Twenty-one patients underwent LSG, and twenty patients underwent MGB followed by open pre-peritoneal mesh repair of ventral hernia. The intra-operative and post-operative characters in both groups were comparable. Three patients developed seroma post-operatively; one patient developed a wound infection and underwent secondary suturing. There was no incidence of mesh infection or hernia recurrence in our follow-up.
Conclusion: Our study shows that concomitant bariatric surgery and open pre-peritoneal mesh repair of ventral hernia is a feasible option with low morbidity, avoidance of mesh-related complications, and at a lower cost to the patient.