Ventral hernias in the bariatric patient

Ventral hernia, a collective term for incisional, umbilical, and other anterior abdominal wall hernias, are common occurrences in the morbidly obese population. The correct management of these hernias in the morbidly obese has an important bearing on the overall outcome of the surgical management of this group of patients. Morbidly obese patients who have concurrent ventral hernias pose a therapeutic dilemma for two reasons: their weight predisposes them to a high recurrence rate, and the field contamination that invariably accompanies opening bowel in the operative field precludes the use of prosthetic meshes. In addition, new incisional hernias have been common long-term complications of open bariatric surgical procedures.