Showing posts with label Obesity. Show all posts
Showing posts with label Obesity. Show all posts
Umblical Hernia in an Obese Patient
Umbilical Hernia in an Obese Patient

Umblical Hernia in a Obese Patient
Umbilical hernia showing as a soft tissue opacity on an erect abdomen X-ray film
Obese patients with umbilical hernia comprise a special group. Apart from anaesthetic considerations for an obese patient, following are few technical points to consider before taking an obese patient for surgery.


Obesity with BMI > 30 kg/m2 is one of the factor for surgical failure[1]

The patient’s BMI >30 kg/m2 and defects >2 cm have been reported as possible factors for surgical failure in a study by Venclauskas et al. Ninety-seven patients (Males:31 and Females:66) with umbilical hernia were examined in this study.  The recurrence rate was higher when hernia size was >2 cm (9% for <2 cm vs 10.5% for >2 cm) and patient's BMI was >30 kg/m(2) (8.6% for < 30 vs 10.7% for >30). 

Thus it is wise to counsel the patient for weight loss before an elective umbilical hernia surgery.

Laparoscopic umbilical hernia repair is better than open repair in Obese patients [2]

A comparative study by Colon et al. (2013) stated that laparoscopic umbilical hernia repair should be the preferred approach in obese patients. They found a significant increase in wound infection rate in the open mesh repair group when compared with the laparoscopic procedure (26% vs. 4%; p<0.05). They observed no hernia recurrence in the laparoscopic group, whereas the open group had 4% recurrence rate.


References

[1] https://www.ncbi.nlm.nih.gov/pubmed/19124962/

[2] https://www.sciencedirect.com/science/article/pii/S0002961012004369



Keywords: Umbilical Hernia and Obesity, Umbilical Hernia, Mesh, Suture, Mesh Repair, Suture Repair, Obesity, BMI

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