Bariatric Surgery and Hernia Surgery

Publication Date: October 1, 2018
Last Updated: March 14, 2022

Conclusions and summary recommendations

• There is a significant link between obesity and hernia formation both after abdominal surgery and de novo. There is also evidence that abdominal wall hernias (AWH) can more commonly present with obstruction or strangulation in patients with obesity.
• There is a higher risk for complications and recurrence after hernia repair in patients with obesity.
• In patients with severe obesity and ventral hernia (VH), and both being amenable to laparoscopic repair, combined hernia repair and metabolic/bariatric surgery (MBS) may be safe and associated with good short-term outcomes and low risk of infection. There is a relative lack of evidence, however, about the use of synthetic mesh in this setting.
• In patients with severe obesity and AWH that is not amenable to laparoscopic repair, a staged approach is recommended. Weight loss, whether through surgery or through multidisciplinary medical management, prior to hernia repair is likely to improve hernia repair outcomes. MBS appears to provide far more significant and rapid weight loss than other modalities and would be a good option for selected patients with severe obesity and large, symptomatic AWH.

Recommendation Grading




Bariatric Surgery and Hernia Surgery

Authoring Organization

Publication Month/Year

October 1, 2018

Last Updated Month/Year

June 8, 2023

Document Type


External Publication Status


Country of Publication


Document Objectives

The American Society for Metabolic and Bariatric Surgery issues the following guidelines for the purpose of enhancing quality of care in hernia treatment through metabolic and bariatric surgery

Target Patient Population

Patients with severe obesity

Inclusion Criteria

Female, Adolescent, Adult, Older adult

Health Care Settings

Ambulatory, Hospital, Operating and recovery room, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant



Diseases/Conditions (MeSH)

D009765 - Obesity, D050110 - Bariatric Surgery, D015431 - Weight Loss, D015992 - Body Mass Index, D006547 - Hernia


obesity, weight loss, bariatric surgery, hernia surgery

Source Citation

Emanuele Lo Menzo et al. / Surgery for Obesity and Related Diseases 14 (2018) 1221–1232