Converting gastric sleeve to bypass - Have a substantial umbilical hernia: Is a combined surgery possible? (Photos)

Hello, I hope you are well. I am sorry to hear you are strugging with your weight again. Even though your hernia is of considerable size, it is possible to get it repaired at the same time as your conversion procedure. Some doctors prefer do hernia repairs as open procedures, however since you are already undergoing a laparoscopic one, it would be good to consider to fix it laparoscopically. I hope ths answer was useful.

The first and most important question:  What is the best option for more weight loss after sleeve gastrectomy?  You say you want to have a gastric bypass conversion.  I think this would be a bad idea.  There is no data to support gastric bypass as a way to lose more weight.  I've seen patients who actually GAINED weight after conversion to bypass.  According to the numbers you provided, you still weigh close to 400 pounds.  You still have a long way to go.  The proven option is the addition of malabsorption to your sleeve, in the form of the duodenal switch. The operation can be calibrated to give you enough malabsorption to help you achieve your goal.The next question is regarding simultaneous repair of your hernia with the bariatric surgery.  You say you have an umbilical hernia, and the laparoscopic photo certainly looks like an umbilical hernia.  But the picture of your abdomen looks like diastasis recti, which is not really a hernia, and should not be repaired other than at the time of an abdominoplasty (tummy tuck).  You may have both.  If the umbilical hernia is repaired, you will still have the diastasis recti.My approach is generally to leave hernias alone until after weight loss is complete.  Bariatric surgery involves cutting the bowel.  If mesh is used to repair the hernia, there is an increased risk of the mesh getting infected.  In your case, however, the tissue stuck in the hernia may get in the way of doing the duodenal switch, so it may have to be fixed at the same time.