Episode 12 - "Complex Hernias + Severe Obesity: The Perfect Surgical Storm"

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Master General Surgery And Trauma

Dr. Jocielle Miranda, MD

22 episodes

5 months ago

Podcast Description – “Master General Surgery and Trauma”

🎙️ Master General Surgery and Trauma is your go-to podcast for cutting-edge discussions on surgical innovation, trauma care, and evidence-based medicine. Developed under the curation of leading experts from General Surgery and Trauma, this podcast explores the most relevant topics shaping modern surgical practice.

Each episode features in-depth analyses of clinical protocols, surgical techniques, trauma management strategies, and patient safety improvements. This podcast is developed by experienced surgeons and academic leaders in General Surgery and Trauma, combining scientific evidence, clinical research, and real-world surgical experience. Each episode delivers carefully curated content that deepens understanding of surgical principles, enhances decision-making, and promotes excellence in patient care.

Whether you’re a surgeon, resident, medical student, or healthcare professional, this podcast provides valuable discussions that bridge the gap between theory and practice in abdominal wall, treatment of surgical complications, emergency surgery, trauma care, and surgical oncology.

🔹 Stay informed.
🔹 Stay prepared.
🔹 Master the art of General Surgery and Trauma.

🎧 Tune in now and take your surgical knowledge to the next level!

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Episode 12 - "Complex Hernias + Severe Obesity: The Perfect Surgical Storm"

Master General Surgery And Trauma

16 minutes

5 months ago

Episode 12 - "Complex Hernias + Severe Obesity: The Perfect Surgical Storm"

🎙️ Episode Title:
Episode 12 - "Complex Hernias + Severe Obesity: The Perfect Surgical Storm"

📝 Episode Description:
In this episode of the Master General Surgery – Abdominal Wall Series, we review the pivotal 2025 study published in Hernia on the feasibility and safety of Laparoscopic Sleeve Gastrectomy (LSG) as the first step in a staged approachfor patients with severe obesity and complex abdominal wall hernias (CAWH) with loss of domain (LOD).While LSG proved feasible and safe with no intraoperative complications or mortality, the study reported a higher-than-expected major complication rate (18.75%), underscoring the technical complexity of these cases. We examine the rationale behind staging, the role of abdominal imaging in surgical planning, and why these patients should only be managed in specialized centers.

Reference:
Dantas ACB, Coelho RC, Lima MC, et al. Feasibility of Laparoscopic Sleeve Gastrectomy in Patients with Severe Obesity and Complex Abdominal Wall Hernias with Loss of Domain: A Randomized Clinical Trial. Hernia. 2025;29:170. https://doi.org/10.1007/s10029-025-03380-1

🔍 Key topics discussed:

Volume ratios (Tanaka/Sabbagh) in LOD assessment
Surgical risks vs. benefits in high-complexity CAWH
Preoperative imaging and planning
Use of LSG as neoadjuvant strategy before hernia repair
Importance of multidisciplinary teams and surgical expertise

🧠 Take-Home Messages:
• LSG is feasible and safe, but not risk-free in LOD scenarios
• Surgical planning must include CT-based volume analysis
• Staged approach aligns with ASMBS/IFSO 2022 guidelines
• Outcomes depend on expert teams and patient selection
• Future research should refine pre-op strategies and assess GLP-1 therapy roles

📡 Listen now on all major platforms and in the Google Classroom of the Abdominal Wall and Content Group – Hospital das Clínicas, University of São Paulo.