Why Consider Weight Loss Surgery with Hernias?
It is widely documented that those who are morbidly obese are at greater risk for developing abdominal wall hernias. “And, those same patients can have a much higher recurrence rate following hernia repair,” says Kevin Tymitz MD, surgeon with the TriHealth Surgical Institute and the Good Samaritan Weight Management Center. More complications, such as infections, fluid collection and skin breakdown can occur in these patients.
So, the morbidly obese (defined as those with a body mass index, or BMI, of greater than 35) are well advised to consider an approach to addressing both conditions, usually in a staged process.
Depending on the size of the hernia, staging procedures oftentimes is recommended. If possible, larger hernias would be repaired after a weight loss surgery procedure. Usually, this is a very safe option considering that the larger hernias rarely develop bowel obstruction or bowel compromise.
Significant weight loss results in major improvement in relaxation on the abdominal wall. This allows for adequate closure of the defect and minimizes the recurrence of the hernia. It is also ideal to take this approach because excess skin resulting from significant weight loss also can be removed at the time of hernia repair.
According to Dr. Tymitz, smaller hernias can be fixed safely at the time of bariatric surgery. Often times, a CT scan is the best way to determine the exact size of the defect, as it may be difficult to determine the size of the hernia based on physical exam alone. At that point, he says, “It can be determined if the hernia repair can be dealt with at the time of the weight loss surgery.” The optimal goal of both weight loss surgery and hernia repair is to ultimately improve patient function with activities of daily living and improve quality of life.