Case Report Laparoscopic Sleeve Gastrectomy in A BMI>50 Patient with A Large Incisional Hernia and Severe Visceroptosis: A Case Report
Laparoscopic Sleeve Gastrectomy in A BMI>50 Patient with A Large Incisional Hernia and Severe Visceroptosis: A Case Report
Zucchini Nicolas1,2, Puddu Silvia1,3*, Moroni Enrico1, Fantola Giovanni1
1Metabolic and Obesity Surgery Unit, ARNAS G. Brotzu, Cagliari, Italy
2Department of Medical, Surgical and Health Sciences, University of Trieste, Italy
3Department of Surgery, University of Cagliari, Azienda Ospedaliero-Universitaria, Presidio Policlinico di Monserrato, Monserrato, Italy
*Corresponding Author: Silvia Puddu, Department of Surgery, University of Cagliari, Azienda Ospedaliero-Universitaria, Presidio Policlinico di Monserrato, Monserrato, Italy
Citation: Nicolas Z, Silvia P, Enrico M, Giovanni F (2025) Laparoscopic Sleeve Gastrectomy in A BMI>50 Patient with A Large Incisional Hernia and Severe Visceroptosis: A Case Report J Surg 10: 11395 DOI: 10.29011/2575-9760.011395
Received Date: 21 July 2025; Accepted Date: 28 July 2025; Published Date: 30 July 2025
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Abstract
Ventral hernias often represent a challenge in obese patients, which in many cases can benefit from bariatric surgery prior to hernia repair. The case presented is about a 53-year-old female patient with severe obesity (BMI 50.7 kg/m²) and a large incisional hernia in the right lower quadrant following right nephrectomy for renal cancer. Her medical history included depression, chronic obstructive pulmonary disease with suspected obstructive sleep apnea, multiple sclerosis, and recently diagnosed diabetes mellitus. Intraoperatively, extensive visceral dislocation was observed, with the spleen displaced into the left flank and the stomach herniated into the incisional defect. A laparoscopic sleeve gastrectomy was performed after extensive adhesiolysis. The procedure was completed without complication and the patient was discharged on postoperative day two. This case supports the feasibility of LSG as a first-stage procedure in complex patients to enable safe future abdominal wall reconstruction.
Keywords: Case Report; Incisional Hernia; Laparoscopic Sleeve Gastrectomy; Multiple Sclerosis; Severe Obesity
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