Skip to main content
Top
Published in: Surgical Endoscopy 9/2023

24-07-2023 | Bariatric Surgery | SAGES/EAES official publication

Management of abdominal wall hernias in patients with severe obesity

Authors: Omar M. Ghanem, Sean Orenstein, S. Julie-Ann Lloyd, Amin Andalib, Alice Race, Holly Ann Burt, Farah Husain, Matthew Goldblatt, Matthew Kroh, SAGES Metabolic, Bariatric Surgery Committee, SAGES Hernia Committee

Published in: Surgical Endoscopy | Issue 9/2023

Login to get access

Abstract

Obesity is a risk factor for abdominal wall hernia development and hernia recurrence. The management of these two pathologies is complex and often entwined. Bariatric and ventral hernia surgery require careful consideration of physiologic and technical components for optimal outcomes. In this review, a multidisciplinary group of Society of American Gastrointestinal and Endoscopic Surgeons’ bariatric and hernia surgeons present the various weight loss modalities available for the pre-operative optimization of patients with severe obesity and concurrent hernias. The group also details the technical aspects of managing abdominal wall defects during weight loss procedures and suggests the optimal timing of definitive hernia repair after bariatric surgery. Since level one evidence is not available on some of the topics covered by this review, expert opinion was implemented in some instances. Additional high-quality research in this area will allow for better recommendations and therefore treatment strategies for these complex patients.
Literature
1.
go back to reference Orenstein SB, Martindale RG (2018) Enhanced recovery pathway for complex abdominal wall reconstruction. Plast Reconstr Surg. 142(3 Suppl):133S-141SPubMedCrossRef Orenstein SB, Martindale RG (2018) Enhanced recovery pathway for complex abdominal wall reconstruction. Plast Reconstr Surg. 142(3 Suppl):133S-141SPubMedCrossRef
2.
go back to reference Davison SP, Parikh PM, Jacobson JM, Iorio ML, Kalan M (2009) A “buttressed mesh” technique for fascial closure in complex abdominal wall reconstruction. Ann Plast Surg 62(3):284–289PubMedCrossRef Davison SP, Parikh PM, Jacobson JM, Iorio ML, Kalan M (2009) A “buttressed mesh” technique for fascial closure in complex abdominal wall reconstruction. Ann Plast Surg 62(3):284–289PubMedCrossRef
3.
go back to reference Eid GM, Wikiel KJ, Entabi F, Saleem M (2013) Ventral hernias in morbidly obese patients: a suggested algorithm for operative repair. Obes Surg 23(5):703–709PubMedCrossRef Eid GM, Wikiel KJ, Entabi F, Saleem M (2013) Ventral hernias in morbidly obese patients: a suggested algorithm for operative repair. Obes Surg 23(5):703–709PubMedCrossRef
4.
go back to reference Kaminski DL (2000) The role of gastric restrictive procedures in treating ventral hernias in morbidly obese patients. Int J Surg Investig 2(2):159–164PubMed Kaminski DL (2000) The role of gastric restrictive procedures in treating ventral hernias in morbidly obese patients. Int J Surg Investig 2(2):159–164PubMed
5.
go back to reference Desai KA, Razavi SA, Hart AM, Thompson PW, Losken A (2016) The effect of bmi on outcomes following complex abdominal wall reconstructions. Ann Plast Surg 76(Suppl 4):S295–S297PubMedCrossRef Desai KA, Razavi SA, Hart AM, Thompson PW, Losken A (2016) The effect of bmi on outcomes following complex abdominal wall reconstructions. Ann Plast Surg 76(Suppl 4):S295–S297PubMedCrossRef
6.
go back to reference Lin HJ, Spoerke N, Deveney C, Martindale R (2009) Reconstruction of complex abdominal wall hernias using acellular human dermal matrix: a single institution experience. Am J Surg 197(5):599–603PubMedCrossRef Lin HJ, Spoerke N, Deveney C, Martindale R (2009) Reconstruction of complex abdominal wall hernias using acellular human dermal matrix: a single institution experience. Am J Surg 197(5):599–603PubMedCrossRef
7.
go back to reference Sauerland S, Korenkov M, Kleinen T, Arndt M, Paul A (2004) Obesity is a risk factor for recurrence after incisional hernia repair. Hernia 8(1):42–46PubMedCrossRef Sauerland S, Korenkov M, Kleinen T, Arndt M, Paul A (2004) Obesity is a risk factor for recurrence after incisional hernia repair. Hernia 8(1):42–46PubMedCrossRef
8.
go back to reference Sugerman HJ, Kellum JM Jr, Reines HD, DeMaria EJ, Newsome HH, Lowry JW (1996) Greater risk of incisional hernia with morbidly obese than steroid-dependent patients and low recurrence with prefascial polypropylene mesh. Am J Surg 171(1):80–84PubMedCrossRef Sugerman HJ, Kellum JM Jr, Reines HD, DeMaria EJ, Newsome HH, Lowry JW (1996) Greater risk of incisional hernia with morbidly obese than steroid-dependent patients and low recurrence with prefascial polypropylene mesh. Am J Surg 171(1):80–84PubMedCrossRef
9.
go back to reference Docimo S Jr, Spaniolas K, Svestka M, Bates AT, Sbayi S, Schnur J et al (2019) Increased incidence of surgical site infection with a body mass index ≥ 35 kg/m(2) following abdominal wall reconstruction with open component separation. Surg Endosc 33(8):2503–2507PubMedCrossRef Docimo S Jr, Spaniolas K, Svestka M, Bates AT, Sbayi S, Schnur J et al (2019) Increased incidence of surgical site infection with a body mass index ≥ 35 kg/m(2) following abdominal wall reconstruction with open component separation. Surg Endosc 33(8):2503–2507PubMedCrossRef
10.
go back to reference Iaroseski J, Harada G, Ramos R, Mottin C, Grossi J (2021) Open RYGB long-term complications: ventral hernia - report on a 10-year single-center experience. Georgian Med News 315:9–13 Iaroseski J, Harada G, Ramos R, Mottin C, Grossi J (2021) Open RYGB long-term complications: ventral hernia - report on a 10-year single-center experience. Georgian Med News 315:9–13
11.
go back to reference Weller WE, Rosati C (2008) Comparing outcomes of laparoscopic versus open bariatric surgery. Ann Surg 248(1):10–15PubMedCrossRef Weller WE, Rosati C (2008) Comparing outcomes of laparoscopic versus open bariatric surgery. Ann Surg 248(1):10–15PubMedCrossRef
12.
go back to reference Nasri BN, Trainor L, Jones DB (2022) Laparoscopic adjustable gastric band remains a safe, effective, and durable option for surgical weight loss. Surg Endosc 36(10):7781–7788PubMedCrossRef Nasri BN, Trainor L, Jones DB (2022) Laparoscopic adjustable gastric band remains a safe, effective, and durable option for surgical weight loss. Surg Endosc 36(10):7781–7788PubMedCrossRef
13.
go back to reference Clapp B, Ponce J, DeMaria E, Ghanem O, Hutter M, Kothari S et al (2022) American society for metabolic and bariatric surgery 2020 estimate of metabolic and bariatric procedures performed in the United States. Surg Obes Relat Dis 18(9):1134–1140PubMedCrossRef Clapp B, Ponce J, DeMaria E, Ghanem O, Hutter M, Kothari S et al (2022) American society for metabolic and bariatric surgery 2020 estimate of metabolic and bariatric procedures performed in the United States. Surg Obes Relat Dis 18(9):1134–1140PubMedCrossRef
14.
go back to reference Borbély Y, Zerkowski J, Altmeier J, Eschenburg A, Kröll D, Nett P (2017) Complex hernias with loss of domain in morbidly obese patients: role of laparoscopic sleeve gastrectomy in a multi-step approach. Surg Obes Relat Dis 13(5):768–773PubMedCrossRef Borbély Y, Zerkowski J, Altmeier J, Eschenburg A, Kröll D, Nett P (2017) Complex hernias with loss of domain in morbidly obese patients: role of laparoscopic sleeve gastrectomy in a multi-step approach. Surg Obes Relat Dis 13(5):768–773PubMedCrossRef
15.
go back to reference Hidalgo JE, Roy M, Ramirez A, Szomstein S, Rosenthal RJ (2012) Laparoscopic sleeve gastrectomy: a first step for rapid weight loss in morbidly obese patients requiring a second non-bariatric procedure. Obes Surg 22(4):555–559PubMedCrossRef Hidalgo JE, Roy M, Ramirez A, Szomstein S, Rosenthal RJ (2012) Laparoscopic sleeve gastrectomy: a first step for rapid weight loss in morbidly obese patients requiring a second non-bariatric procedure. Obes Surg 22(4):555–559PubMedCrossRef
16.
go back to reference Morrell DJ, Pauli EM, Lyn-Sue JR, Haluck RS, Rogers AM (2021) Laparoscopic sleeve gastrectomy in patients with complex abdominal wall hernias. Surg Endosc 35(7):3881–3889PubMedCrossRef Morrell DJ, Pauli EM, Lyn-Sue JR, Haluck RS, Rogers AM (2021) Laparoscopic sleeve gastrectomy in patients with complex abdominal wall hernias. Surg Endosc 35(7):3881–3889PubMedCrossRef
17.
go back to reference Newcomb WL, Polhill JL, Chen AY, Kuwada TS, Gersin KS, Getz SB et al (2008) Staged hernia repair preceded by gastric bypass for the treatment of morbidly obese patients with complex ventral hernias. Hernia 12(5):465–469PubMedCrossRef Newcomb WL, Polhill JL, Chen AY, Kuwada TS, Gersin KS, Getz SB et al (2008) Staged hernia repair preceded by gastric bypass for the treatment of morbidly obese patients with complex ventral hernias. Hernia 12(5):465–469PubMedCrossRef
18.
go back to reference Abu Dayyeh BK, Bazerbachi F, Vargas EJ, Sharaiha RZ, Thompson CC, Thaemert BC et al (2022) Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomised trial. Lancet 400(10350):441–451PubMedCrossRef Abu Dayyeh BK, Bazerbachi F, Vargas EJ, Sharaiha RZ, Thompson CC, Thaemert BC et al (2022) Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomised trial. Lancet 400(10350):441–451PubMedCrossRef
19.
go back to reference Abu Dayyeh BK, Maselli DB, Rapaka B, Lavin T, Noar M, Hussan H et al (2021) Adjustable intragastric balloon for treatment of obesity: a multicentre, open-label, randomised clinical trial. Lancet 398(10315):1965–1973PubMedCrossRef Abu Dayyeh BK, Maselli DB, Rapaka B, Lavin T, Noar M, Hussan H et al (2021) Adjustable intragastric balloon for treatment of obesity: a multicentre, open-label, randomised clinical trial. Lancet 398(10315):1965–1973PubMedCrossRef
20.
go back to reference Abboud DM, Yao R, Rapaka B, Ghazi R, Ghanem OM, Abu Dayyeh BK (2022) Endoscopic management of weight recurrence following bariatric surgery. Front Endocrinol 13:946870CrossRef Abboud DM, Yao R, Rapaka B, Ghazi R, Ghanem OM, Abu Dayyeh BK (2022) Endoscopic management of weight recurrence following bariatric surgery. Front Endocrinol 13:946870CrossRef
21.
go back to reference Abu Dayyeh B, Portela R, Mahmoud T, Ghazi R, Ghanem OM (2022) A novel approach for weight regain after Roux-en-Y gastric bypass: Staged transoral outlet reduction (TORe) followed by surgical type 1 distalization. VideoGIE 7(4):135–137PubMedPubMedCentralCrossRef Abu Dayyeh B, Portela R, Mahmoud T, Ghazi R, Ghanem OM (2022) A novel approach for weight regain after Roux-en-Y gastric bypass: Staged transoral outlet reduction (TORe) followed by surgical type 1 distalization. VideoGIE 7(4):135–137PubMedPubMedCentralCrossRef
22.
go back to reference Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM et al (2016) American association of clinical endocrinologists and American college of endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract 22(Suppl 3):1–203PubMedCrossRef Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM et al (2016) American association of clinical endocrinologists and American college of endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract 22(Suppl 3):1–203PubMedCrossRef
23.
go back to reference Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA et al (2014) 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American college of cardiology/American heart association task force on practice guidelines and the obesity society. Circulation 129(25 Suppl 2):S102–S138PubMed Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA et al (2014) 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American college of cardiology/American heart association task force on practice guidelines and the obesity society. Circulation 129(25 Suppl 2):S102–S138PubMed
24.
go back to reference Bernardi K, Olavarria OA, Dhanani NH, Lyons N, Holihan JL, Cherla DV et al (2022) Two-year outcomes of prehabilitation among obese patients with ventral hernias: a randomized controlled trial (NCT02365194). Ann Surg 275(2):288–294PubMedCrossRef Bernardi K, Olavarria OA, Dhanani NH, Lyons N, Holihan JL, Cherla DV et al (2022) Two-year outcomes of prehabilitation among obese patients with ventral hernias: a randomized controlled trial (NCT02365194). Ann Surg 275(2):288–294PubMedCrossRef
25.
go back to reference Chan G, Chan CK (2005) A review of incisional hernia repairs: preoperative weight loss and selective use of the mesh repair. Hernia 9(1):37–41PubMedCrossRef Chan G, Chan CK (2005) A review of incisional hernia repairs: preoperative weight loss and selective use of the mesh repair. Hernia 9(1):37–41PubMedCrossRef
26.
go back to reference Rosen MJ, Aydogdu K, Grafmiller K, Petro CC, Faiman GH, Prabhu A (2015) A multidisciplinary approach to medical weight loss prior to complex abdominal wall reconstruction: is it feasible? J Gastrointest Surg 19(8):1399–1406PubMedCrossRef Rosen MJ, Aydogdu K, Grafmiller K, Petro CC, Faiman GH, Prabhu A (2015) A multidisciplinary approach to medical weight loss prior to complex abdominal wall reconstruction: is it feasible? J Gastrointest Surg 19(8):1399–1406PubMedCrossRef
27.
go back to reference Sun BJ, Valdez D, Duong D, Gupta R, Smith BR (2017) Evaluation of preoperative weight loss for elective hernia repair in the veteran population. Am Surg 83(10):1112–1116PubMedCrossRef Sun BJ, Valdez D, Duong D, Gupta R, Smith BR (2017) Evaluation of preoperative weight loss for elective hernia repair in the veteran population. Am Surg 83(10):1112–1116PubMedCrossRef
28.
go back to reference Dadashzadeh ER, Huckaby LV, Handzel R, Hossain MS, Sanin GD, Anto VP et al (2022) The risk of incarceration during nonoperative management of incisional hernias: a population-based analysis of 30,998 patients. Ann Surg 275(2):e488–e495PubMedCrossRef Dadashzadeh ER, Huckaby LV, Handzel R, Hossain MS, Sanin GD, Anto VP et al (2022) The risk of incarceration during nonoperative management of incisional hernias: a population-based analysis of 30,998 patients. Ann Surg 275(2):e488–e495PubMedCrossRef
29.
go back to reference Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B et al (2022) Tirzepatide once weekly for the treatment of obesity. N Engl J Med 387(3):205–216PubMedCrossRef Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B et al (2022) Tirzepatide once weekly for the treatment of obesity. N Engl J Med 387(3):205–216PubMedCrossRef
31.
go back to reference Menzo EL, Hinojosa M, Carbonell A, Krpata D, Carter J, Rogers AM (2018) American society for metabolic and bariatric surgery and American hernia society consensus guideline on bariatric surgery and hernia surgery. Surg Obes Relat Dis 14(9):1221–1232PubMedCrossRef Menzo EL, Hinojosa M, Carbonell A, Krpata D, Carter J, Rogers AM (2018) American society for metabolic and bariatric surgery and American hernia society consensus guideline on bariatric surgery and hernia surgery. Surg Obes Relat Dis 14(9):1221–1232PubMedCrossRef
32.
go back to reference Moolla M, Dang J, Modasi A, Byrns S, Switzer N, Birch DW et al (2020) Concurrent laparoscopic ventral hernia repair with bariatric surgery: a propensity-matched analysis. J Gastrointest Surg 24(1):58–66PubMedCrossRef Moolla M, Dang J, Modasi A, Byrns S, Switzer N, Birch DW et al (2020) Concurrent laparoscopic ventral hernia repair with bariatric surgery: a propensity-matched analysis. J Gastrointest Surg 24(1):58–66PubMedCrossRef
33.
go back to reference Moszkowicz D, Jacota M, Nkam L, Giovinazzo D, Grimaldi L, Lazzati A (2021) Ventral hernia repair and obesity: results from a nationwide register study in france according to the timeframes of hernia repair and bariatric surgery. Obes Surg 31(12):5251–5259PubMedCrossRef Moszkowicz D, Jacota M, Nkam L, Giovinazzo D, Grimaldi L, Lazzati A (2021) Ventral hernia repair and obesity: results from a nationwide register study in france according to the timeframes of hernia repair and bariatric surgery. Obes Surg 31(12):5251–5259PubMedCrossRef
34.
go back to reference Praveen Raj P, Bhattacharya S, Saravana Kumar S, Parthasarathi R, Cumar B, Palanivelu C (2019) Morbid obesity with ventral hernia: is concomitant bariatric surgery with laparoscopic ventral hernia mesh repair the best approach? an experience of over 150 cases. Surg Obes Relat Dis 15(7):1098–1103PubMedCrossRef Praveen Raj P, Bhattacharya S, Saravana Kumar S, Parthasarathi R, Cumar B, Palanivelu C (2019) Morbid obesity with ventral hernia: is concomitant bariatric surgery with laparoscopic ventral hernia mesh repair the best approach? an experience of over 150 cases. Surg Obes Relat Dis 15(7):1098–1103PubMedCrossRef
35.
go back to reference Ahmad G, Baker J, Finnerty J, Phillips K, Watson A (2019) Laparoscopic entry techniques. Cochrane Database Syst Rev 1(1):Cd06583 Ahmad G, Baker J, Finnerty J, Phillips K, Watson A (2019) Laparoscopic entry techniques. Cochrane Database Syst Rev 1(1):Cd06583
36.
go back to reference Philips PA, Amaral JF (2001) Abdominal access complications in laparoscopic surgery. J Am Coll Surg 192(4):525–536PubMedCrossRef Philips PA, Amaral JF (2001) Abdominal access complications in laparoscopic surgery. J Am Coll Surg 192(4):525–536PubMedCrossRef
37.
go back to reference Datta T, Eid G, Nahmias N, Dallal RM (2008) Management of ventral hernias during laparoscopic gastric bypass. Surg Obes Relat Dis 4(6):754–757PubMedCrossRef Datta T, Eid G, Nahmias N, Dallal RM (2008) Management of ventral hernias during laparoscopic gastric bypass. Surg Obes Relat Dis 4(6):754–757PubMedCrossRef
38.
go back to reference Eid GM, Mattar SG, Hamad G, Cottam DR, Lord JL, Watson A et al (2004) Repair of ventral hernias in morbidly obese patients undergoing laparoscopic gastric bypass should not be deferred. Surg Endosc 18(2):207–210PubMedCrossRef Eid GM, Mattar SG, Hamad G, Cottam DR, Lord JL, Watson A et al (2004) Repair of ventral hernias in morbidly obese patients undergoing laparoscopic gastric bypass should not be deferred. Surg Endosc 18(2):207–210PubMedCrossRef
39.
go back to reference Krivan MS, Giorga A, Barreca M, Jain VK, Al-Taan OS (2019) Concomitant ventral hernia repair and bariatric surgery: a retrospective analysis from a UK-based bariatric center. Surg Endosc 33(3):705–710PubMedCrossRef Krivan MS, Giorga A, Barreca M, Jain VK, Al-Taan OS (2019) Concomitant ventral hernia repair and bariatric surgery: a retrospective analysis from a UK-based bariatric center. Surg Endosc 33(3):705–710PubMedCrossRef
40.
go back to reference Spaniolas K, Kasten KR, Mozer AB, Sippey ME, Chapman WH, Pories WJ et al (2015) Synchronous ventral hernia repair in patients undergoing bariatric surgery. Obes Surg 25(10):1864–1868PubMedCrossRef Spaniolas K, Kasten KR, Mozer AB, Sippey ME, Chapman WH, Pories WJ et al (2015) Synchronous ventral hernia repair in patients undergoing bariatric surgery. Obes Surg 25(10):1864–1868PubMedCrossRef
41.
go back to reference Sukeik M, Alkari B, Ammori BJ (2007) Abdominal wall hernia during laparoscopic gastric bypass: a serious consideration. Obes Surg 17(6):839–842PubMedCrossRef Sukeik M, Alkari B, Ammori BJ (2007) Abdominal wall hernia during laparoscopic gastric bypass: a serious consideration. Obes Surg 17(6):839–842PubMedCrossRef
42.
go back to reference Vilallonga R, Fort JM, Gonzalez O, Baena JA, Lecube A, Armengol M (2011) Management of patients with hernia or incisional hernia undergoing surgery for morbid obesity. J Obes 2011:860942PubMedCrossRef Vilallonga R, Fort JM, Gonzalez O, Baena JA, Lecube A, Armengol M (2011) Management of patients with hernia or incisional hernia undergoing surgery for morbid obesity. J Obes 2011:860942PubMedCrossRef
43.
go back to reference Maroun J, Li M, Oyefule O, Badaoui JE, McKenzie T, Kendrick M et al (2022) Ten year comparative analysis of sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with duodenal switch in patients with BMI ≥ 50 kg/m(2). Surg Endosc 36(7):4946–4955PubMedCrossRef Maroun J, Li M, Oyefule O, Badaoui JE, McKenzie T, Kendrick M et al (2022) Ten year comparative analysis of sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with duodenal switch in patients with BMI ≥ 50 kg/m(2). Surg Endosc 36(7):4946–4955PubMedCrossRef
44.
go back to reference Portela R, Mehta K, Vahibe A, McKenzie T, Kendrick M, Ghanem OM (2022) The omental plug: a novel management approach of concomitant ventral hernias during bariatric surgery. Surg Laparosc Endosc Percutan Tech 32(4):514–516PubMedCrossRef Portela R, Mehta K, Vahibe A, McKenzie T, Kendrick M, Ghanem OM (2022) The omental plug: a novel management approach of concomitant ventral hernias during bariatric surgery. Surg Laparosc Endosc Percutan Tech 32(4):514–516PubMedCrossRef
45.
go back to reference Blatnik JA, Krpata DM, Jacobs MR, Gao Y, Novitsky YW, Rosen MJ (2012) In vivo analysis of the morphologic characteristics of synthetic mesh to resist MRSA adherence. J Gastrointest Surg 16(11):2139–2144PubMedCrossRef Blatnik JA, Krpata DM, Jacobs MR, Gao Y, Novitsky YW, Rosen MJ (2012) In vivo analysis of the morphologic characteristics of synthetic mesh to resist MRSA adherence. J Gastrointest Surg 16(11):2139–2144PubMedCrossRef
46.
go back to reference Novitsky YW, Fayezizadeh M, Majumder A, Neupane R, Elliott HL, Orenstein SB (2016) Outcomes of posterior component separation with transversus abdominis muscle release and synthetic mesh sublay reinforcement. Ann Surg 264(2):226–232PubMedCrossRef Novitsky YW, Fayezizadeh M, Majumder A, Neupane R, Elliott HL, Orenstein SB (2016) Outcomes of posterior component separation with transversus abdominis muscle release and synthetic mesh sublay reinforcement. Ann Surg 264(2):226–232PubMedCrossRef
47.
go back to reference Warren JA, Epps M, Debrux C, Fowler JL 3rd, Ewing JA, Cobb WS 4th, Carbonell AM (2015) Surgical site occurrences of simultaneous panniculectomy and incisional hernia repair. Am Surg 81(8):764–769PubMedCrossRef Warren JA, Epps M, Debrux C, Fowler JL 3rd, Ewing JA, Cobb WS 4th, Carbonell AM (2015) Surgical site occurrences of simultaneous panniculectomy and incisional hernia repair. Am Surg 81(8):764–769PubMedCrossRef
Metadata
Title
Management of abdominal wall hernias in patients with severe obesity
Authors
Omar M. Ghanem
Sean Orenstein
S. Julie-Ann Lloyd
Amin Andalib
Alice Race
Holly Ann Burt
Farah Husain
Matthew Goldblatt
Matthew Kroh
SAGES Metabolic, Bariatric Surgery Committee, SAGES Hernia Committee
Publication date
24-07-2023
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 9/2023
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-023-10312-6

Other articles of this Issue 9/2023

Surgical Endoscopy 9/2023 Go to the issue