Incisional Hernia Prophylaxis in Morbidly Obese Patients Undergoing Biliopancreatic Diversion

Currò, Giuseppe; Centorrino, Tommaso; Musolino, Cinzia; Sarra, Giuseppe; Navarra, Giuseppe
October 2011
Obesity Surgery;Oct2011, Vol. 21 Issue 10, p1559
Academic Journal
Background: The development of incisional hernia after open bariatric surgery is a major cause of morbidity and hospital readmission. The use of prosthetic material in clean-contaminated procedures remains controversial and correlated to high rate of local complications. A prospective observational clinical study on two different surgical techniques used to close the abdominal wall has been performed to better assess the safety (primary end point) and the efficacy (secondary end point) of polypropylene mesh placement to prevent incisional hernia in morbidly obese patients undergoing biliopancreatic diversion (BPD). Methods: Between January 2007 and February 2009, two consecutive series of 25 obese patients, each undergoing BPD, have been analyzed to compare prophylactic retrorectal muscle prosthetic mesh placement with conventional suture repair of the abdominal wall. The first 25 consecutive patients selected to BPD underwent abdominal closure without mesh (group A), and the next 25 consecutive ones have been treated with prophylactic retrorectal muscle prosthetic mesh placement (group B). Results: No mesh infection occurred in patients in group B. The incidence of minor local complications (seroma or hematoma) was similar in both groups. The incidence of incisional hernia was significantly higher ( p = 0.009) in no-mesh group (group A) than in the mesh group (group B) at 1-year follow-up (range, 12 to 24 months). The incidence of incisional hernia was 4% (one case reported) in the group treated with mesh versus an incidence of 32% (eight cases reported) in the group conventionally closed. Conclusions: The mesh placement in clean-contaminated bariatric surgery seems to be safe (primary end point) and effective (secondary end point) at 1-year follow-up.


Related Articles

  • Petersen's hernia as a complication of bariatric surgery: CT findings. Ximenes, M.; Baroni, R.; Trindade, R.; Racy, M.; Tachibana, A.; Moron, R.; Funari, M.; Ximenes, M A S; Baroni, R H; Trindade, R M C; Racy, M C J; Moron, R A; Funari, M B G // Abdominal Imaging;Apr2011, Vol. 36 Issue 2, p126 

    Referrals for bariatric surgery have currently increased due to the need for more effective interventions in the management of severely obese patients. The Roux-en-Y gastric bypass is currently one of the preferred procedures, and internal hernias are the main causes of late postoperative...

  • Complications of Bariatric Surgery: Implications for the Covering Physician. TANNER, BENJAMIN D.; ALLEN, JEFFREY W. // American Surgeon;Feb2009, Vol. 75 Issue 2, p103 

    Bariatric surgery is the only effective option for sustained weight loss for morbidly obese patients. The increasing prevalence of obesity in America and the application of a laparoscopic approach to bariatric surgery have combined to dramatically increase the number of patients undergoing these...

  • Cardiorespiratory Fitness and Short-term Complications After Bariatric Surgery.  // Cardiopulmonary Physical Therapy Journal (American Physical Ther;Dec2006, Vol. 17 Issue 4, p138 

    The article determines which patients are more likely to have serious postoperative complications after undertaking bariatric surgery due to obesity. The authors found that aerobic fitness level, defined as a peak VO2 of 15.8 ml/kg/min was the cut point for patients who experienced these...

  • Change in Sexual Dysfunction Following Bariatric Surgery. Wingfield, Laura; Kulendran, Myutan; Laws, Georgia; Chahal, Harvinder; Scholtz, Samantha; Purkayastha, Sanjay // Obesity Surgery;Feb2016, Vol. 26 Issue 2, p387 

    Obesity is associated with multiple comorbidities and psychosocial burdens, but often sexual dysfunction (SD) is overlooked. Bariatric surgery is the most effective treatment for morbid obesity, and its role in reversing SD is reviewed. A literature search of MEDLINE, PubMed Central, and...

  • Weight-loss surgery is best after all else fails. CHUA, PHILIP S. // Filipino Reporter;12/11/2015, Vol. 44 Issue 2, p23 

    The article offers information on weight-loss surgery which is performed on obese patients. Topics include bariatric surgery which is the general term used for operative procedures performed on the stomach, things done in gastric bypass including stapling the stomach and bypassing a small part...

  • Prevalence of Defaecatory Disorders in Morbidly Obese Patients Before and After Bariatric Surgery. Sileri, Pierpaolo; Franceschilli, Luana; Cadeddu, Federica; Luca, Elisabetta; D'Ugo, Stefano; Tognoni, Valeria; Camperchioli, Ida; Benavoli, Domenico; Lorenzo, Nicola; Gaspari, Achille; Gentileschi, Paolo // Journal of Gastrointestinal Surgery;Jan2012, Vol. 16 Issue 1, p62 

    Background: The prevalence of obesity is increasing worldwide and has lately reached epidemic proportions in western countries. Several epidemiological studies have consistently shown that both overweight and obesity are important risk factors for the development of various functional...

  • Mechanism Underlying the Weight Loss and Complications of Roux-en-Y Gastric Bypass. Review. Abdeen, G; Roux, CW // Obesity Surgery;Feb2016, Vol. 26 Issue 2, p410 

    Various bariatric surgical procedures are effective at improving health in patients with obesity associated co-morbidities, but the aim of this review is to specifically describe the mechanisms through which Roux-en-Y gastric bypass (RYGB) surgery enables weight loss for obese patients using...

  • Barriers in the Approach of Obese Patients Undergoing Bariatric Surgery in Flemish Hospitals. Gesquiere, Ina; Augustijns, Patrick; Lannoo, Matthias; Matthys, Christophe; Schueren, Bart; Foulon, Veerle // Obesity Surgery;Nov2015, Vol. 25 Issue 11, p2153 

    Background: Bariatric surgery is associated not only with weight loss and improvement of comorbidities of obesity but also with short and long-term complications. Preoperative screening and lifelong follow-up of these patients are important to optimize the effect of bariatric surgery and...

  • What Will We Do Now with the Super-Obese Patient Undergoing Total Hip Arthroplasty? Commentary on an article by Kimona Issa, MD, et al.: "Bariatric Orthopaedics: Total Hip Arthroplasty in Super-Obese Patients (Those with a BMI of ≥50 kg/m2)". Robinson, Raymond Paul // Journal of Bone & Joint Surgery, American Volume;2/3/2016, Vol. 98 Issue 3, pe12 

    The author comments on the retrospective study on obese patients who undergone total hip arthroplasty. Topics discussed include the complexities and outcomes of total hip surgery in obese patients and the challenge of finding surgeons who will conduct the surgery. Also emphasized is the impact...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics