Can I Have a Gastric Bypass Revision at the Same Time As the Ventral Hernia Repair?

I need to have ventral hernia repair and I am also contemplating revision surgery to reduce the size of my pouch back to where it was when I first had surgery.

Doctor Answers 2

Hernia and revision surgery.

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It all depends on what type of revision surgery you are having.  Most hernias need to be fixed with mesh and you can't use mesh if any of the gi tract is opened because of the risk of infection.  I in general do not recommend revising a gastric pouch because of the very high rate of complications and leaks.  I recommend Lap-band over the gastric bypass which can also be done at the same time as a hernia repair with mesh.

Abdominal hernia repair and revision surgery

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Most often the repair of an abdominal hernia is staged or delayed in a gastric bypass patient. This would be the best approach since reducing weight makes the repair easier and more effective over time.  Also with a delayed operation one can use mesh to reinforce the repair which is required for almost all types of abdominal wall hernias.

There are times when a hernia is very bothersome or as determined by the surgeon  it has to be closed at the time of the operation and this repair will probably not use mesh and therefore will not be as "strong" as  a repair that uses mesh. There reason for not using mesh at the same time during a bypass or some types of revision is that cutting the bowel or stomach can increase the chance of having a mesh infection after surgery.

Ricardo M. Bonnor, MD, FACS
Houston General Surgeon

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