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ArticleHernia : the journal of hernias and abdominal wall surgery2025

Concomitant bariatric surgery and hernia repair: A Data-Driven answer to a longstanding surgical dilemma.

Pradeep Joshua Christopher, Saravana Kumar S, Jayanth Leo Xl, Prabhakaran S, Ishwarya Nagarajan, Muthamizhselvi Ayyasamy, Praveen Raj Palanivelu, Palanivelu Chinnusamy

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Article in Hernia : the journal of hernias and abdominal wall surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 citing paper in PubMed.

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5 · Who and what money

Authors and funding

8 authors.

Pradeep Joshua ChristopherDepartment of AWR, Upper GI and Bariatric surgery, Gem hospital and research institute, Pankaja mills road, Ramanathapuram Coimbatore, Coimbatore, Tamil Nadu, 641023, India. pdp.joshua@gmail.com.ORCID 0000-0002-1949-9652
Saravana Kumar SDepartment of AWR, Upper GI surgery and Bariatric Surgery, Gem hospital and Research Institute, Coimbatore, India.
Jayanth Leo XlDepartment of Bariatric and Metabolic Surgery, Gem hospital and Research Institute, Chennai, India.
Prabhakaran SDepartment of Anaesthesiology, Gem hospital and research institute, Coimbatore, India.
Ishwarya NagarajanDepartment of Metabolic and Bariatric Surgery, Gem hospital and Research Institute, Chennai, India.
Muthamizhselvi AyyasamyDepartment of Metabolic and Bariatric Surgery, Gem hospital and Research Institute, Coimbatore, India.
Praveen Raj PalaniveluDepartment of Obesity and Diabetes Surgery, Gem hospital and research institute, Coimbatore, India.
Palanivelu ChinnusamySurgical Gastroenterology Chairman, Gem hospital and Research Institute, Coimbatore, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the safety, efficacy, and long-term outcomes of concomitant laparoscopic bariatric surgery and ventral hernia repair in obese patients. Obesity and ventral hernia frequently coexist, often presenting a surgical dilemma. Historically, concerns over mesh infections, extended operative time, and increased morbidity have led to a preference for staged procedures. However, with advancements in laparoscopic techniques and increasing evidence supporting mesh placement in clean-contaminated fields, the concomitant approach has gained acceptance. High-quality data from large-volume centers remain limited till now.

methodThis retrospective study was conducted at a tertiary care center between January 2003 and December 2023. A total of 353 patients underwent simultaneous bariatric surgery-either laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (LRYGB), or mini-gastric bypass (MGB-OAGB)-with ventral hernia repair using intraperitoneal onlay mesh (IPOM), eTEP-Ventral RS, or eTEP-TAR techniques. The Primary objective of the study was to assess the complication and recurrence rates. Secondary objective included operative time, hospital stay, and postoperative recovery.

resultsOf the 353 patients, 224 underwent LSG, 74 LRYGB, and 55 MGB-OAGB. IPOM was used in 90% of cases. The overall complication rate was low, with seroma (2.3%), ileus (2.6%), hematoma (1.1%) and Surgical site occurrences (SSO) (3.4%) being the most common. No mesh infections or anastomotic leaks were observed. Mean operative time ranged from 124 to 167 min, and average hospital stay was 3.1 ± 1.1 days. At one-year follow-up in 268 patients (80%), hernia recurrence was 0.6%.

conclusionsConcomitant laparoscopic bariatric surgery with hernia repair is a safe and effective option in appropriately selected patients, with excellent outcomes and minimal complications.

Indexed as

Bariatric SurgeryHernia, VentralHerniorrhaphyLaparoscopyObesity, MorbidAdultFemaleGastric BypassHumansLength of StayMaleMiddle AgedOperative TimePostoperative ComplicationsRecurrenceRetrospective StudiesBariatric surgeryConcomitant surgeryIntra-abdominal pressureLaparoscopic ventral hernia repairMetabolic surgeryObesityVentral hernia

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.