Concurrent mesh repair of a Morgagni and umbilical hernia during a laparoscopic sleeve gastrectomy in a morbidly obese individual

Nik Ritza Kosai Nik Mahmood, R. Reynu, H. S. Gendeh, Srijit Das, M. Lakdawala

Research output: Contribution to journalArticle

Abstract

Morgagni Hernia is a rare form of diaphragmatic hernia. It is mainly asymptomatic and often identified incidentally during surgery. Tension-free synthetic mesh repair is the preferred treatment modality. However, the use of synthetic mesh concurrently during a clean-contaminated surgery such as sleeve gastrectomy remains controversial due to the remote possibility of mesh infection. A middle-aged female with BMI of 47 Kg/m2 was admitted electively for laparoscopic sleeve gastrectomy with concurrent umbilical hernia repair. Intra-operatively, a left Morgagni Hernia containing omentum and a segment of transverse colon was noted. She underwent a laparoscopic sleeve gastrectomy and simultaneous laparoscopic tension-free composite mesh repair of both Morgagni and umbilical hernia. Outpatient review three months later revealed excess weight loss of almost 30% with no recurrence of either hernia. In conclusion, the advantages of concurrent hernia repair during bariatric surgery outweigh the risk of mesh infection and should be performed to prevent future risk of visceral herniation and strangulation. Laparoscopic mesh repair of a Morgagni Hernia and umbilical hernia in the setting of an electively planned sleeve gastrectomy is feasible, effective and safe in the hands of a trained laparoscopic surgeon.

Original languageEnglish
Pages (from-to)87-92
Number of pages6
JournalJournal of Krishna Institute of Medical Sciences University
Volume5
Issue number4
Publication statusPublished - 1 Oct 2016

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Umbilical Hernia
Gastrectomy
Herniorrhaphy
Transverse Colon
Omentum
Diaphragmatic Hernia
Bariatric Surgery
Hernia
Infection
Weight Loss
Outpatients
Recurrence
Congenital Diaphragmatic Hernias
Therapeutics

Keywords

  • Gastrectomy
  • Laparoscopy
  • Mesh
  • Morgagni
  • Obesity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Concurrent mesh repair of a Morgagni and umbilical hernia during a laparoscopic sleeve gastrectomy in a morbidly obese individual",
abstract = "Morgagni Hernia is a rare form of diaphragmatic hernia. It is mainly asymptomatic and often identified incidentally during surgery. Tension-free synthetic mesh repair is the preferred treatment modality. However, the use of synthetic mesh concurrently during a clean-contaminated surgery such as sleeve gastrectomy remains controversial due to the remote possibility of mesh infection. A middle-aged female with BMI of 47 Kg/m2 was admitted electively for laparoscopic sleeve gastrectomy with concurrent umbilical hernia repair. Intra-operatively, a left Morgagni Hernia containing omentum and a segment of transverse colon was noted. She underwent a laparoscopic sleeve gastrectomy and simultaneous laparoscopic tension-free composite mesh repair of both Morgagni and umbilical hernia. Outpatient review three months later revealed excess weight loss of almost 30{\%} with no recurrence of either hernia. In conclusion, the advantages of concurrent hernia repair during bariatric surgery outweigh the risk of mesh infection and should be performed to prevent future risk of visceral herniation and strangulation. Laparoscopic mesh repair of a Morgagni Hernia and umbilical hernia in the setting of an electively planned sleeve gastrectomy is feasible, effective and safe in the hands of a trained laparoscopic surgeon.",
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T1 - Concurrent mesh repair of a Morgagni and umbilical hernia during a laparoscopic sleeve gastrectomy in a morbidly obese individual

AU - Nik Mahmood, Nik Ritza Kosai

AU - Reynu, R.

AU - Gendeh, H. S.

AU - Das, Srijit

AU - Lakdawala, M.

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Morgagni Hernia is a rare form of diaphragmatic hernia. It is mainly asymptomatic and often identified incidentally during surgery. Tension-free synthetic mesh repair is the preferred treatment modality. However, the use of synthetic mesh concurrently during a clean-contaminated surgery such as sleeve gastrectomy remains controversial due to the remote possibility of mesh infection. A middle-aged female with BMI of 47 Kg/m2 was admitted electively for laparoscopic sleeve gastrectomy with concurrent umbilical hernia repair. Intra-operatively, a left Morgagni Hernia containing omentum and a segment of transverse colon was noted. She underwent a laparoscopic sleeve gastrectomy and simultaneous laparoscopic tension-free composite mesh repair of both Morgagni and umbilical hernia. Outpatient review three months later revealed excess weight loss of almost 30% with no recurrence of either hernia. In conclusion, the advantages of concurrent hernia repair during bariatric surgery outweigh the risk of mesh infection and should be performed to prevent future risk of visceral herniation and strangulation. Laparoscopic mesh repair of a Morgagni Hernia and umbilical hernia in the setting of an electively planned sleeve gastrectomy is feasible, effective and safe in the hands of a trained laparoscopic surgeon.

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