Department of Surgery, Mayo Clinic, Rochester, MN.
Surg Laparosc Endosc Percutan Tech. 2022 Aug 1;32(4):514-516. doi: 10.1097/SLE.0000000000001062.
Severe obesity leads to a higher incidence of ventral hernias, thus complicating up to 8% of bariatric procedures. The optimal management of these hernias continues to be a controversial topic. We present our novel approach of utilizing an omental plug for concomitant ventral hernia management during metabolic surgery.
To prevent early bowel incarceration and obstruction during bariatric surgery, we sutured the omentum circumferentially to the edges of the hernia defect and to the hernia sac itself with absorbable suture.
Four patients were managed with this novel omental plug technique. All patients were female. The mean age was 53 years (range 39 to 68 y), the mean body-mass index was 54.75 kg/m 2 (range 49 to 59 kg/m 2 ), and the mean follow-up was 4.6 months (range 1.5 to 6.5 mo). There were no hernia-related complications through the follow-up period.
The omental plug technique is a feasible, inexpensive, and safe alternative for ventral hernias with the potential prevention of bowel incarceration during bariatric surgery. This approach allows deferring the definitive hernia repair for a later stage.
严重肥胖会导致更高的腹疝发病率，从而使多达 8%的减重手术变得复杂。这些疝的最佳处理方法仍然是一个有争议的话题。我们提出了一种新的方法，即在代谢手术中利用网膜塞来同时处理腹侧疝。
为了防止减重手术期间早期发生肠嵌顿和梗阻，我们用可吸收缝线将网膜环绕缝合到疝缺损边缘和疝囊本身。
有 4 名患者采用了这种新的网膜塞技术进行治疗。所有患者均为女性，平均年龄 53 岁（范围 39 至 68 岁），平均体重指数为 54.75kg/m 2 （范围 49 至 59kg/m 2 ），平均随访时间为 4.6 个月（范围 1.5 至 6.5 个月）。在随访期间，没有与疝相关的并发症。
网膜塞技术是一种可行、经济且安全的方法，适用于腹侧疝，有可能在减重手术中预防肠嵌顿。这种方法可以将确定性疝修复推迟到后期进行。
