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Morbid obesity, hernia repair

Bing-Sheng Lin, Yan-Shen Shan, Wan-Chen Liu, Chin-Han Wu, Pei-Ying Wu, Keng-Fu Hsu
BACKGROUND: Obesity is a risk factor for the development of endometrial cancer and abdominal wall hernias. We report a case of tension pneumoperitoneum that developed after gynecological surgery and mesh repair of a ventral hernia. CASE PRESENTATION: A 57-year-old Asian Taiwanese woman with a body mass index of 52.9 (kg/m2 ) underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy due to endometrial cancer, and ventral herniorrhaphy with mesh due to ventral hernia...
March 20, 2018: Journal of Medical Case Reports
Steve Halligan, Sam G Parker, Andrew A Plumb, Alastair C J Windsor
Complex ventral hernia (CVH) describes large, anterior, ventral hernias. The incidence of CVH is rising rapidly due to increasing laparotomy rates in ever older, obese and co-morbid patients. Surgeons with a specific interest in CVH repair are now frequently referring these patients for imaging, normally computed tomography scanning. This review describes what information is required from preoperative imaging and the surgical options and techniques used for CVH repair, so that radiologists understand the postoperative appearances specific to CVH and are aware of the common complications following surgery...
March 12, 2018: European Radiology
P Palumbo, S Usai, C Amatucci, B Perotti, L Ruggeri, G Illuminati, G Tellan
BACKGROUND: The extension of indications for procedures in a Day Surgery (DS) setting has led to changes in the anesthetic and surgical treatment of Inguinal Hernias (IH). According to the recommendations of the European Hernia Society, the treatment of IH in DS units should be performed under Monitored Anesthesia Care (MAC). PATIENTS AND METHODS: 960 patients underwent IH repairs over a period of 24 months. The patients were randomly divided into two groups: R (remifentanil) and F (fentanyl); the group F was considered as a control group...
November 2017: Il Giornale di Chirurgia
Hisham Hussan, Emmanuel Ugbarugba, Michael T Bailey, Kyle Porter, Bradley Needleman, Sabrena Noria, Benjamin O'Donnell, Steven K Clinton
BACKGROUND AND AIMS: Clostridium difficile infection (CDI) is major health care concern with reports linking it to obesity. Our aim was to investigate the little known impact of the two most common bariatric surgeries, Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG), on risk of CDI admissions. METHODS: This is a retrospective cohort study using the 2013 Nationwide Readmission Database. We examined inpatient CDI rates within 120 days after RYGB (n = 40,059) and VSG (n = 45,394)...
February 5, 2018: Obesity Surgery
S Hajibandeh, S Hajibandeh, R Deering, D McEleney, J Guirguis, S Dix, A Sreh, E Toner, A El Muntasar, A Kausar, G Sheikh, D OShea, A Shafiq, A Kelly, A Khan, D Arumugam, A Evans
OBJECTIVES: To determine the baseline accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of routinely collected co-morbidity data in patients undergoing abdominal wall hernia repair. METHODS: All patients aged > 18 who underwent umbilical, para-umbilical, inguinal or incisional hernia repair between 1 January 2015 and 1 November 2016 were identified. All parts of the clinical notes were searched for co-morbidities by two authors independently...
April 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Patrick Hamid Alizai, Anne Andert, Eric Lelaona, Ulf Peter Neumann, Christian Daniel Klink, Marc Jansen
BACKGROUND: Obese patients are often required to lose weight prior to incisional hernia repair as obesity is thought to increase postoperative complications and recurrence rates. The aim of this study was to determine the impact of BMI on the outcome after laparoscopic and open incisional hernia repair. MATERIALS AND METHODS: In a cohort study from May 2012 to August 2016, 178 patients underwent incisional hernia repair: 90 patients open SUBLAY and 88 patients laparoscopic intraperitoneal onlay mesh (IPOM)...
December 2017: International Journal of Surgery
Dmitry Zavlin, Kevin T Jubbal, Jeffrey L Van Eps, Barbara L Bass, Warren A Ellsworth, Anthony Echo, Jeffrey D Friedman, Brian J Dunkin
BACKGROUND: Metabolic syndrome (MetS) entails the simultaneous presence of a constellation of dangerous risk factors including obesity, diabetes, hypertension, and dyslipidemia. The prevalence of MetS in Western society continues to rise and implies an elevated risk for surgical complications and/or poor surgical outcomes within the affected population. OBJECTIVE: To assess the risks and outcomes of multi-morbid patients with MetS undergoing open ventral hernia repair...
September 22, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Peter Mekhail, Akbar Ashrafi, Mario Mekhail, David Hatcher, Monish Aron
INTRODUCTION: Parastomal hernia is a common and vexing problem after ileal conduit urinary diversion that can cause pain, bowel symptoms, and problems with the stoma appliance, resulting in leakage, odor, and impairment of quality of life. Historically, these hernias have been managed open surgically, which requires considerable dissection of the abdominal wall for mesh placement, and may also require relocating the stoma to the contralateral side. Further, open parastomal hernia repair can be a morbid procedure with recurrence rates of approximately 30%...
September 7, 2017: Urology
Mark A Suckow, Felicia D Duke Boynton, Chad Johnson
Ventral abdominal hernia is a relatively common clinical condition that sometimes requires herniorraphy (surgical repair). The repair of ventral abdominal hernia typically requires implantation of a material to serve as a mechanical bridge across the defect in the abdominal wall. Biomaterials, such as porcine small intestinal submucosa (SIS), also serve as a lattice for cell growth into the implant and can naturally incorporate into the host tissue. Development of such repair materials benefits from use of animal models in which experimental abdominal wall defects are easily created and are amenable to repair in a reproducible fashion...
October 2, 2017: Journal of Visualized Experiments: JoVE
Nathaniel R Ellens, Joshua E Simon, Kimberly D Kemmeter, Tyler W Barreto, Paul R Kemmeter
BACKGROUND: Both hiatal hernias (HH) and morbid obesity significantly contribute to gastroesophageal reflux disease, which increases the risk for esophagitis and esophageal cancer. Therefore, concomitant HH repair is recommended during bariatric surgery procedures. Unfortunately, recurrence of HH after repair is not uncommon and the optimal surgical technique has yet to be established. OBJECTIVE: To evaluate the feasibility of recreating the phrenoesophageal ligaments by adding phrenoesophagopexy to HH repair during sleeve gastrectomy...
December 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Daniel Pucheril, Brian Chun, Deepansh Dalela, Firas Abdollah, Scott A Laker, Craig G Rogers
Background: Ureter involvement within indirect hernias is a rare phenomenon usually identified incidentally during herniorrhaphy. Even more rare are extraperitoneal ureteral inguinal hernias, which represent about 20% of these cases and are characterized by a substantial amount of extraperitoneal fat in the hernia defect, the absence of a peritoneal sac, and associated with hydroureteronephrosis and nephroptosis. To date, repair of ureteral inguinal hernias has been performed exclusively using open surgical techniques...
2017: Journal of Endourology Case Reports
Amber L Shada, Miloslawa Stem, Luke M Funk, Jacob A Greenberg, Anne O Lidor
BACKGROUND: Paraesophageal hernia (PEH) is a common condition that bariatric surgeons encounter. Expert opinion is split on whether bariatric surgery and PEH repair should be completed concurrently or sequentially. We hypothesized that concurrent bariatric surgery and PEH repair is safe. OBJECTIVES: We examined 30-day outcomes after concomitant PEH repair and bariatric surgery. SETTING: National database, United States. METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program database (2011-2014), we identified patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) with or without PEH repair...
January 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Michael Osseis, Andrea Lazzati, Chady Salloum, Concepcion Gomez Gavara, Philippe Compagnon, Cyrille Feray, Chetana Lim, Daniel Azoulay
BACKGROUND: Knowledge regarding the feasibility and safety of sleeve gastrectomy (SG) in obese liver transplant recipients is scarce. We report our experience of sleeve gastrectomy following liver transplantation (LT). METHODS: All patients who had undergone LT and subsequently underwent SG at our institution were retrospectively reviewed. Surgical outcomes, liver and kidney function tests, outcomes of obesity-related comorbidities, and excess weight loss were analyzed...
January 2018: Obesity Surgery
Ramachandra Kolachalam, Eugene Dickens, Lawrence D'Amico, Christopher Richardson, Jorge Rabaza, Reza Gamagami, Anthony Gonzalez
BACKGROUND: Minimally invasive inguinal hernia repair (IHR) in general and particularly in obese patients has not been widely adopted, potentially due to the perceived technical challenges and the well-documented learning curve associated with laparoscopic repair. Outcomes in robotic-assisted IHR in obese (BMI ≥ 30 kg/m(2)) patients have not been described and warrant study. METHODS: Seven surgeons conducted a multicenter retrospective chart review of their early robotic-assisted IHR (RHR) cases and compared them with their open IHR (OHR) cases...
June 23, 2017: Surgical Endoscopy
Kersten E Reider
BACKGROUND: A 54-year-old morbidly obese woman with a small bowel obstruction and large ventral hernia was admitted to hospital. She underwent an exploratory laparotomy, lysis of adhesions, and ventral hernia repair with mesh placement. She subsequently developed an enteroatmospheric fistula; several months of hospital care was required to effectively manage the wound and contain effluent from the fistula. METHODS: Several approaches were used to manage output from the fistula during her hospital course...
May 2017: Journal of Wound, Ostomy, and Continence Nursing
Fabrizio Rebecchi, Marco E Allaix, Marco G Patti, Francisco Schlottmann, Mario Morino
Laparoscopic sleeve gastrectomy (LSG) has reached wide popularity during the last 15 years, due to the limited morbidity and mortality rates, and the very good weight loss results and effects on comorbid conditions. However, there are concerns regarding the effects of LSG on gastroesophageal reflux disease (GERD). The interpretation of the current evidence is challenged by the fact that the LSG technique is not standardized, and most studies investigate the presence of GERD by assessing symptoms and the use of acid reducing medications only...
April 7, 2017: World Journal of Gastroenterology: WJG
Mary M Mrdutt, Yolanda Munoz-Maldonado, Justin L Regner
BACKGROUND: Anecdotally, obese patients experience increased morbidity with emergent ventral hernia repair (VHR). We hypothesized obese patients are over-represented in emergent VHRs and experience increased 30-day morbidity. METHODS: American College of Surgeons National Surgical Quality Improvement Program database (2011 to 2013) was queried for patients undergoing open VHR. Patients were stratified by body mass index (BMI) categories: underweight, normal weight, overweight, and obesity classes I, II, and III; 30-day postoperative complications (surgical site infections, return to operating room, dehiscence, death) were evaluated across BMI for elective vs emergent VHR...
December 2016: American Journal of Surgery
Marvin Louis Roy Lu, Akanksha Agarwal, Josh Sloan, Aaron Kosmin
INTRODUCTION: Spontaneous bacterial peritonitis can be differentiated from secondary bacterial peritonitis by the absence of a surgically treatable intra-abdominal source of infection. However, oftentimes this is unapparent and other clinical clues need to be sought after to make the right diagnosis. CASE: A 64-year-old woman was admitted because of three days of worsening diffuse abdominal pain and distention. She was morbidly obese and had a history of non-alcoholic steatohepatitis (NASH) cirrhosis...
2017: IDCases
Yves Borbély, Jens Zerkowski, Julia Altmeier, Anna Eschenburg, Dino Kröll, Philipp Nett
BACKGROUND: Morbid obesity and its associated co-morbidities are risk factors for the development of abdominal hernias, add complexity to their repair, and increase perioperative risk. Repair of hernias with loss of domain (LoD) is further complicated by risk of abdominal compartment syndrome. A staged concept with an initial weight loss procedure might enable a reposition of the herniated viscera, improve co-morbidities for, and prohibit abdominal compartment syndrome in the subsequent repair...
May 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Yan Mei Goh, Ajay Tokala, Tarek Hany, Kishore G Pursnani, Ravindra S Date
Portomesenteric venous thrombosis (PMVT) is a rare but well-reported complication following laparoscopic surgery. We present three cases of PMVT following laparoscopic surgery. Our first case is a 71-year-old morbidly obese woman admitted for elective laparoscopic giant hiatus hernia (LGHH) repair. Post-operatively, she developed multi-organ dysfunction and computed tomography scan revealed portal venous gas and extensive small bowel infarct. The second patient is a 51-year-old man with known previous deep venous thrombosis who also had elective LGHH repair...
April 2017: Journal of Minimal Access Surgery
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