Can a gastric sleeve to bypass revision be done at the same time as umbilical hernia repair with mesh?

Question

Hi.I would like to do sleeve to bypass revision along with hernia repair with mesh but i am told that umbilical hernia with mesh cannot be repaired during sleeve to bypass revision.I am 46 years old and have had 2 umbilical repairs done without mesh before. I do not want to have 2 separate surgeries :-(

Jorge Maytorena, MD · Answer

Preferably, it is not advisable to perform hernia repair at the same time as sleeve to bypass conversion surgery as it increases the risk of infection and complications. What I advise is that you value and weigh what is a priority for you, and based on that, make the decision.

Ricardo Vega, MD · Answer

Thank you for your inquiry, yes it can be done however labs should be ran first before procedure but there should be no probelm doing so at the same time, I suggest seeking board certified surgeons. Best of luck

Ali Solmaz, MD · Answer

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.

Walfre Edwin Guerrero Burgueno, MD · Answer

While it is possible to combine umbilical hernia repair with a sleeve-to-bypass revision, the decision to use mesh depends on several factors, including the size and location of the hernia and your previous surgeries. But if you have a medical history of two umbilical hernia repairs without mesh, it is best to place it. In some cases, mesh may not be recommended during bariatric revisions because it increases the risk of infection.
Overall, the data suggest that a staged approach in which bariatric surgery is performed prior to hernia repair is ideal for larger abdominal hernias requiring mesh placement. A concomitant approach is appropriate for hernias that the surgeon feels does not require mesh. 
Patients undergoing abdominal hernia repair during bariatric surgery do not experience higher mortality. However, these patients have an elevated risk of major complications with this risk being higher among patients undergoing abdominal hernia repair and Laparoscopic RY Gastric Bypass. We should consider these risks when choosing to perform abdominal hernia repair at the time of bariatric surgery.

Islam Abdelkhalek, MD · Answer

Yes, it is advised not to do the 2 operations together. You should do the the revision operation first snf after one year you go to the hernia repair with mesh.

Edgar Serrano, MD - Account Suspended · Answer

The decision to perform a revision from a gastric sleeve to a gastric bypass and an umbilical hernia repair with mesh simultaneously depends on several factors and should be thoroughly discussed with your healthcare team. It's essential to consider the potential risks and benefits associated with combining these procedures.
Here are some factors to consider:
Overall Health Status: Your general health will play a significant role in determining if you are a suitable candidate for combined procedures. If you are in good health, it may be more feasible to undergo both surgeries simultaneously.Surgeon's Recommendation: The surgeon will assess your individual case and provide recommendations based on factors such as your medical history, the severity of the hernia, and the need for gastric surgery revision.Surgical Complexity: Combining different surgical procedures increases the complexity of the surgery. The surgeon will evaluate whether it is safe and feasible to perform both procedures in a single operation.Recovery Considerations: Combining surgeries may affect the overall recovery process. It's important to understand the potential impact on your postoperative care, rehabilitation, and recovery time.Nutritional Considerations: Gastric bypass surgery can affect nutrient absorption, and combining it with a hernia repair may have implications for your nutritional status. Your healthcare team will need to monitor and manage your nutritional needs carefully.Individualized Care: Every patient is unique, and the decision to combine surgeries should be based on an individualized assessment of your health, medical history, and surgical needs.It's crucial to have detailed discussions with both your bariatric surgeon and the surgeon performing the hernia repair to ensure a comprehensive understanding of the potential risks and benefits. Additionally, obtaining a second opinion can provide valuable insights into whether combining these procedures is the most appropriate course of action for your specific situation.
Always consult with your healthcare providers to make informed decisions about your medical care. They can provide personalized advice based on your health status and individual circumstances.

Felipe Garcia, MD - Account Suspended · Answer

Hi, we need to check all your case but is posible repaired the umbilical hernia in the same surgery!

Pablo Garcia, MD - Account Suspended · Answer

Hopes this finds you well. 
Although many surgeons prefer to perform the interventions at different operative times, it is possible for both to be performed during the same surgery. As long as the pertinent evaluations are performed beforehand, such as imaging studies to determine the size of the hernial defect and whether or not any organ is compromised by it, such studies could be a CT scan with or without contrast medium, in addition to the labs and routine preoperative evaluations.

Can a gastric sleeve to bypass revision be done at the same time as umbilical hernia repair with mesh?

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