Background

Ventral hernias are commonly found in bariatric patients, but there is limited understanding of how repairing the hernia during bariatric surgery affects the procedure's efficacy and recurrence rates. We investigated simultaneous small-sized ventral hernia repair (VHR) at the time of weight loss surgery and its effect on 30-day weight loss outcomes and recurrence.

Methods

With IRB approval, we retrospectively reviewed 525 patients undergoing robotically-assisted laparoscopic bariatric surgery with and without small-sized VHR (<4 cm) from 2019-2023. We propensity score-matched patients who did and did not receive VHR on age, BMI, and race for sleeve gastrectomy (SG) and on age and history of hypertension for Roux-en-Y gastric bypass (RYGB). We used the Mann-Whitney U test to analyze 30-day weight loss outcomes (p-value<0.05). Ventral Hernia Recurrence Inventory (VHRI) questionnaire and imaging records were used to define hernia recurrence.

Results

Of 87% VHRI questionnaire respondents, only 6% had recurrence. For SG, median BMI was 41(42+-5.2) kg/m2, and for RYGB, median BMI was 45(47+-8.5) kg/m2. Weight loss at 30 days was greater in patients with RYGB and VHR compared to RYGB alone by 1.0 kg (p=0.01). Weight loss at 30 days in SG with and without VHR was the same (p=0.92). (Table 1)

Conclusions

Small-sized VHR and bariatric surgery has favorable weight loss success and low hernia recurrence rates; therefore, we recommend considering both procedures simultaneously.