When a sleeve-to-bypass revision is planned, it is not uncommon for surgeons to hesitate about repairing an umbilical hernia with mesh at the same time. The main reason is related to the risk of contamination. Any revisional bariatric surgery involves opening the stomach and intestine, which increases the likelihood of exposure to gastric or intestinal contents. If a synthetic mesh is placed in that same operative field, it carries a higher risk of infection, and an infected mesh can be a very serious complication requiring removal. That being said, every patient’s case is different. Factors such as the size of the hernia, the type of mesh considered, your history of two prior hernia repairs without mesh, and the complexity of your planned revision all come into play. Some surgeons may consider using a biologic mesh, which is more resistant to infection, or staging the repair depending on your risk profile. Others may feel that a small hernia can be repaired without mesh at the same time as your revision, especially if it is straightforward. Your concern about undergoing two separate operations is very understandable, particularly given your age and surgical history. In many cases, surgeons will individualize the approach and sometimes perform both procedures together if they feel the infection risk is low or if the hernia is symptomatic and must be addressed. What matters most is having a detailed discussion with your bariatric surgeon and, if needed, a hernia specialist. Together, they can review your imaging, operative history, and overall health to weigh whether the benefits of a combined operation outweigh the risks.