Seyfi Emir

By Hasan Erdem, Seyfi Emir and Selim Sözen

Part of the book: Hernia Surgery

By Seyfi Emir, Hasan Erdem, Mehmet Gençtürk, Muhammed Said Dalkılıç, Abdullah Şişik and Selim Sözen

Obesity is one of the most important health problems in developed and developing countries. Morbid obesity is defined as having a body mass index (BMI) of more than 40 kg/m2. Obesity does not only predispose to gastroesophageal reflux, but is also an important independent risk factor for the development of hiatal hernia (HH). There are articles advocating about half of obese patients have a hiatal hernia. Hiatal hernia not only exacerbates reflux symptoms, but may also lead to incomplete removal of the gastric fundus during laparoscopic sleeve gastrectomy (LSG). When hiatal hernias are seen preoperatively or intraoperatively for bariatric surgery, surgical correction should ideally be made with mesh reinforcement to prevent further clinical progression.

Part of the book: Hernia Surgery

By Suat Benek, İlhan Bali, Seyfi Emir and Selim Sözen

The incidence of incisional hernia after intra-abdominal surgery is approximately 10–15%. Midline incisions are riskier than other incisions. Smoking, surgical site infections, conditions that impair wound healing, and incorrect surgical technique are among the risk factors, especially obesity. It typically presents as swelling on or near the incision. Computed tomography or ultrasonography can be performed for incisional hernias that cannot be detected by physical examination. Preoperative CT scan is important for the surgical strategy, especially for ventral hernias larger than 10 cm and with loss of space. The surgical strategy may vary depending on the size of the hernia. Tension-free repair is accepted as the standard approach by many authors, and suture repair alone is rarely used. The technique of separating into anterior or posterior components can be used in hernias larger than 10 cm with loss of space. Reconstruction using prosthesis material placed preperitoneally (underlay or sublay) is the most commonly used method today.

Part of the book: Hernia Updates and Approaches