Raquel A Maia, MD, Lee Leng Loh, RN, Hrishikesh Salgaonkar, MS, Sujith Wijerathne, FRCS, Asim Shabir, MBBS, MMed, FRCS, Davide Lomanto, MD, PhD, FAMS. National University Singapore
With the growing incidence of abdominal hernias due to the high volume of laparotomies performed annually and the exponential global growth of obesity in the last decades both, general surgeons and specialists in bariatric surgery, have a new dilemma: when and how to operate an obese patient with ventral hernia.
In our experience at National University Hospital in Singapore, 25 patients with BMI ≥30, underwent preoperative weight management by a specialized bariatric team either for 4 weeks with a regime of 1400 calories or a very low- calorie diet (VLCD) of 800 calories under hospitalization care based on patient compliance and weight loss. We compared the results between patients underwent weight loss management with a VLCD, patients with a diet of 1400 per day and patients without any type of weight management on the preoperative period and their results after surgery, from 2016 to June 2018. We evaluate 28 consecutive patients with mean BMI 29,5 and max BMI 41,2, for elective ventral hernia repair. Fifteen patients underwent laparoscopic ventral hernia repair with prosthetic mesh in an intra peritoneal approach with defect closure (IPOM- plus); 9 patients had a robotic ventral hernia mesh repair with a preperitoneal approach (PPOM) and 4 patients a synchronous ventral hernia repair and bariatric procedure with LSG and IPOM plus approach for the hernia repair. In our mean follow up of 18 months no recurrence was seen, 1 patient was converted to open due to strong adhesions, no mesh or wound infection was noted.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95658
Program Number: P549
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster