Patients having weight loss surgery (WLS), either primary or revision, are sometimes also diagnosed with having a hernia. Whether a hernia can be repaired concurrently with WLS depends on the type of hernia and the type of weight loss surgery. Book an appointment to discuss hernia treatment with Bangalore's top expert, Dr Sumit Talwar.
The two most common hernias encountered in weight loss surgical patients are 1—hiatal hernias & 2 Ventral hernia refers to defects or weaknesses of the abdominal wall. An incisional hernia is diagnosed if this involves a previous midline incision. These hernias may present with any or all of the following findings; protrusions or bulging of the anterior abdominal wall tissue through the abdominal muscle cavity, abdominal pain, and nausea and vomiting.
Hiatal hernias are inside the abdominal cavity at the junction of the esophagus and the stomach at the diaphragm level. This condition is where the upper portion of the stomach, usually located in the abdominal cavity, has migrated through the esophageal hiatus into the chest cavity. These hernias are generally present with reflux and episodes of nausea.
The surgical treatment of these hernias is very different:
Ventral hernia repairs may require mesh placement. Different mesh products are available. Some are made with non-absorbable material, and others are absorbable- biological material that lasts long enough to allow incorporation by the patient's tissue. When a mesh is used, the incidence of hernia recurrence goes down significantly. However, there is an increase in complications associated with the use of mesh. These may include infection of the mesh, and serum. To add another layer of complexity, when the hernia is encountered at the time of weight loss surgery, especially when the GI tract has to be opened ( in the case of a duodenal switch, or a gastric bypass), then it is recommended that no mesh be placed because of the high incidence of mesh infection or the associated complications. In extreme cases where the abdominal wall cannot be closed, biologic meshes may be used with the understanding that a repeat hernia repair may be required later.
Hietal hernias are always repaired at the time of the weight loss surgical procedures. Depending on the type of weight loss surgery the patient has had, the type of hernia repair, whether or not a mesh needs to be utilized, and the amount of stomach and fundus remains for the repair will dictate how the Hiatal hernia is repaired.
Book an appointment to discuss hernia treatment with Bangalore's top expert, Dr Sumit Talwar.
