About 25% of patients who have open gastric bypass surgery develop incisional hernias. These lead to serious complications. Holding the incision closed with a polypropylene mesh can prevent these hernias.
A small, randomised clinical trial reported today in BJS studied 74 seriously obese patients who had a gastric bypass. Polypropylene mesh was used to help close the incision in 34 patients, while 36 patients received standard sutures alone.
The result was clear – none of the patients with mesh closures developed hernias, while hernias occurred in eight of those who only had sutures.
"Developing a hernia is the most common reason why patients return to hospital after a gastric bypass, so finding that mesh can prevent this is important," says lead author Dr Janusz Strzelczyk, who works in the Department of General and Transplant Surgery at Barlicki Hospital, Lodz, Poland.
Using the mesh did not affect any other aspect of the treatment, including the length of a patient's stay in hospital, or the overall cost of the procedure.
The authors believe that surgeons should now consider using mesh as a standard procedure in these sorts of operations. They believe this is particularly the case as the epidemic of obesity is likely to drive this form of surgery from specialist centres to general hospitals.
BJS