Bariatric Surgery (Laparoscopic Sleeve Gastrectomy) with Cholecystectomy and a Large Incisional Hernia (4x5 cm) Repair on a Morbidly Obese Patient BMI Measuring 53 (kg/m2) - RG Hospitals, Ludhiana.

Faculty:
Dr. Rohtash Luthra (Consultant - General, Laparoscopic & Bariatric Surgery)
Dr. Yugam (Sr. Consultant - Anaesthesia)

Hospital:
RG Hospitals, Ludhiana, Punjab.

Presenting/Chief Complaints:
A 41 year old female presented with pain in the lower abdomen. She had history of 2 pelvic surgeries with pfannensteil incision.
On examination she had an incisional hernia of size approximately 4x5 cm. She was Morbidly Obese with a BMI of 53 (kg/m2) (Weight 120 kgs, Height 5’1) and was recently diagnosed with diabetes. She also had symptoms of Obstructive Sleep Apnea.
Patient was counselled for Bariatric Surgery and also about recurrence of hernia with this BMI. NCCT abdomen was done to exactly see the hernia and incidental gallstones were also detected.

Diagnosis:
Morbid Obesity BMI - 53 (kg/m2) with a Large Incisional Hernia (4x5 cm) and Multiple Gallbladder Stones.

Treatment/Procedure/Surgery:
Laparoscopic sleeve gastrectomy with cholecystectomy and incisional hernia repair was done.

Operative Findings:
Laparoscopic Sleeve Gastrectomy was not the procedure of choice with this BMI but because of the large incisional hernia and dense small bowel and omental adhesions in the pelvis bypass procedure was not done and it was informed to the patient preoperatively.

Course of Hospitalization and Condition of Patient at the Time of Discharge:
Patient is very compliant and is doing really well. She has lost 20 kgs in 2 months post surgery.