Dept./Institute of Minimal Access Bariatric and Metabolic Surgery, Gem Hospital and Research Centre, Coimbatore, India.
Obes Surg. 2012 May;22(5):685-9. doi: 10.1007/s11695-012-0614-3.
To analyze the safety in combing laparoscopic ventral hernia repair with a mesh and bariatric surgery.
Obesity is one of the important precipitating factors for primary and recurrent ventral hernias (incisional and umbilical) and it is not uncommon to find these hernias in patients opting for obesity surgery. But, with no consensus or recommendation and concern of mesh infection, surgeons fear in combining these procedures, especially Roux en Y gastric bypass and sleeve gastrectomy.
In this study, we have retrospectively analyzed all patients who underwent concomitant bariatric procedure and mesh repair for ventral hernia at our institute.
A total of 36 out of 765 patients operated at our institute between 2003 and 2011 had concomitant procedures. Eleven patients had Roux en Y gastric bypass (group I) and remaining 25 had sleeve gastrectomy (group II) performed on them. The operating times were 149 min(120-210 min) in group I and 122 min (90-220min) in group II. No immediate complications or any incidence of mesh infection or recurrence in either of the groups.
Concomitant mesh repair for ventral hernias can be safely combined with bariatric procedures like Roux en Y gastric bypass and sleeve gastrectomy. But, for beginners, these should be done only in selected cases after fully informed consent from the patients.
分析腹腔镜下腹膜修补术联合网状物和减重手术的安全性。
肥胖是原发性和复发性腹疝(切口疝和脐疝)的重要诱发因素之一,在选择肥胖手术的患者中,这些疝并不罕见。但是,由于缺乏共识或建议,并且担心网状物感染,外科医生害怕将这些手术联合起来,特别是 Roux-en-Y 胃旁路术和袖状胃切除术。
在这项研究中,我们回顾性分析了在我院同时接受减重手术和网状物修复治疗腹疝的所有患者。
在 2003 年至 2011 年期间,我院共对 765 例患者进行了手术,其中 36 例患者同时进行了手术。11 例患者接受 Roux-en-Y 胃旁路术(I 组),其余 25 例患者接受袖状胃切除术(II 组)。I 组的手术时间为 149 分钟(120-210 分钟),II 组的手术时间为 122 分钟(90-220 分钟)。两组均无即时并发症,也未发生网状物感染或复发。
腹疝的网状物修补术可以与 Roux-en-Y 胃旁路术和袖状胃切除术等减重手术安全地联合使用。但是,对于初学者来说,只有在获得患者充分知情同意的情况下,才能在选择的病例中进行这些手术。