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One stage onlay hernia repair with abdominoplasty in patients following gastric bypass surgery

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Iljin A., Antoszewski B., Zieliński T., Skulimowski A., Szymański D., Strzelczyk J.
Polish Journal of Surgery
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2018
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vol. 90(6)
32-36
EN
Purpose: 1. Evaluation of results after one-time incisional hernia repair (IHR) modo on-lay and abdominoplasty (Ab-pl) in patients after loss of weight following previous Roux-en-Y Gastric Bypass – RYGB. 2. Analysis of differences in quality of life (QL) changes in bariatric patients before RYGB, as well as before and after abdominal contouring operation. Material and Methods: Clinical analysis involved 20 patients with abdominal disfigurement (following RYGB, and massive weight loss) who underwent one-time IHR using on-lay method together with abdominoplasty. We estimated postoperative results, as well as changes in QL, before RYGB and before and after abdominal contouring procedure (based on DAS 24 and SF-36 scales) in comparison with stage before surgeries. Results: Complications - abnormal wound healing (infection, local necrosis) and pneumonia were found in two persons, seroma in two cases, whereas dysesthesia in four patients. We confirmed QL improvement in all aspects after each stage of treatment. Conclusions: 1. One-stage on-lay hernia repair and abdominoplasty is a safe method improving the functioning of patients. 
2. All stages of bariatric treatment resulted in gradual improvement of the quality of life. 3. High BMI in patients before onlay incisional hernia repair with abdominoplasty increases the risk of complications, which is connected with longer hospital stay.
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Long-term results of incisional hernia repair with concomitant abdominoplasty in postbariatric patients

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Iljin A., Antoszewski B., Durczyński A., Lewandowicz E., Strzelczyk J.
Polish Journal of Surgery
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2016
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vol. 88(3)
147-154
EN
The aim of the study was evaluation of long-term results after simultaneous incisional hernia repair and abdominoplasty in patients following RYGB (Roux-en-Y Gastric By-pass) and estimation of quality of life before and after this complex operation. Material and methods. We analyzed long-term results in 18 patients who underwent complex anterior abdominal wall surgery after massive weight loss, following previous RYGB. The patients were followed-up for at least 8 years. We compared the quality of life before and after hernia repair combined with abdominoplasty. Results. Observed wide postoperative scar in 4 persons, permanent dysesthesia in one, and flaccidity of the anterior abdominal wall in three cases. Estimation of the quality of life revealed significant improvement in functional, aesthetic and psychological aspects after complex surgery. Conclusions. 1. Simultaneous incisional hernia repair and abdominoplasty resulted in satisfactory long-term postoperative results, which confirms the efficiency of complex anterior abdominal wall surgery in patients following RYGB after massive weight loss. 2. Surgery in patients afflicted with disfigurements of the anterior abdominal wall contributed to significant improvement in their life quality in functional, aesthetic and psychological aspects, as compared with preoperative estimations. 3. All persons confirmed positive influence of abdominal wall surgery on their possibility to take challenges in life, and fulfill plans. 4. Surgery of the anterior abdominal wall deformities, if needed after massive weight loss, should become an integral part of complex multidisciplinary treatment in postbariatric individuals.
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