Complex Hernias with Loss of Domain in Morbidly Obese Patients: Role of Laparoscopic Sleeve Gastrectomy in a Multi-Step Approach

Morbid obesity and its associated comorbidities are risk factors for the development of abdominal hernias, add complexity to their repair, and increase the perioperative risk. The repair of hernias with loss of domain (LoD) is further complicated by the risk of abdominal compartment syndrome (ACS). A staged concept with an initial weight loss procedure might enable a reposition of the herniated viscera, improve comorbidities for and prohibit ACS in the subsequent repair.