Department of Surgery, Mayo Clinic, Rochester, MN, 55905, USA.
Division of Gastrointestinal and General Surgery, Oregon Health and Science University, Portland, OR, USA.
Surg Endosc. 2023 Sep;37(9):6619-6626. doi: 10.1007/s00464-023-10312-6. Epub 2023 Jul 24.
Obesity is a risk factor for abdominal wall hernia development and hernia recurrence. The management of these two pathologies is complex and often entwined. Bariatric and ventral hernia surgery require careful consideration of physiologic and technical components for optimal outcomes. In this review, a multidisciplinary group of Society of American Gastrointestinal and Endoscopic Surgeons' bariatric and hernia surgeons present the various weight loss modalities available for the pre-operative optimization of patients with severe obesity and concurrent hernias. The group also details the technical aspects of managing abdominal wall defects during weight loss procedures and suggests the optimal timing of definitive hernia repair after bariatric surgery. Since level one evidence is not available on some of the topics covered by this review, expert opinion was implemented in some instances. Additional high-quality research in this area will allow for better recommendations and therefore treatment strategies for these complex patients.
肥胖是腹壁疝发展和疝复发的一个危险因素。这两种病理的治疗都很复杂，往往交织在一起。减重和腹疝手术需要仔细考虑生理和技术因素，以获得最佳效果。在这篇综述中，一组来自美国胃肠内镜外科学会的减重和疝外科医生的多学科团队介绍了各种减肥方法，可用于术前优化严重肥胖和并发疝的患者。该团队还详细介绍了在减肥手术过程中处理腹壁缺陷的技术方面，并建议在减重手术后进行疝修复的最佳时机。由于本综述涵盖的一些主题没有一级证据，因此在某些情况下采用了专家意见。该领域的更多高质量研究将为这些复杂患者提供更好的建议和治疗策略。
