Sleeve and Ventral Hernias

There is strong association between obesity and ventral hernia. Obesity is not only increasing the risk of developing ventral hernia (VH) but also increasing the risk of perioperative complications and recurrence rate. Surgical treatment of Obesity (Bariatric Surgery) is the most effective treatment and increasing worldwide. Bariatric surgeries that are most commonly performed are laparoscopic sleeve gastrectomy (LSG) followed by Roux-en-Y gastric bypass (RYGB). Being obese and having ventral hernia makes bariatric surgery challenging. For small umbilical or incisional hernias, concurrent LSG and VH repair can be done safely. However, a sequential LSG followed by VH repair is recommended for asymptomatic VH with unfavorable anatomy or significant medical co-morbidities. Complexity of ventral hernia associated with obesity requires a careful approach. Successful treatment should be individualized based on patient’s symptoms and concern.