Need advice about combo hernia repair, panniculectomy & wound closure.

Howdy yall,

I hope you don't mind me coming over here to ask if anyone can give me guidance on what to ask the surgeon I am meeting with tomorrow. Here's the situation.

I had distal RNY 2 years ago. I'm still losing, and have lost about 160 pounds, down from a high of 456. I still have 100+ to lose, but my dang stomach flab is hanging PAST my knees. I look like a different person when I am standing up with a skirt on, then I get the spread when I sit down.

Anyway, last Dec. I had emergency surgery for a small bowel obstruction--strangulation of intestines wrapped around surgical adhesions. I left the hospital with my incision open because I contracted 3 hospital acquired infections. Since then I have had another surgery to open the wound completely and I've been on a wound vac for 7 months. The wound is about halfway healed, but it is in some of my flab that hangs.

I had a CT scan on Thurs. The scan revealed that I have a ventral hernia. A part of the incision of my muscle wall where I had surgery in Dec has parted and I have protruding intestine. It must be repaired immediately. I've already had a few instances of where the bowel was in distress, but I walked around, went to the bathroom, etc., and removed the pressure.

The original surgeon who did my SBO surgery is a trauma guy. He doesn't see patients. The surgeon who did my second surgery retired. The guy who did my RNY is hundreds of miles away and doesn't take my insurance anymore.

The surgeon I'm seeing tomorrow was a WLS in PA before he came to my town. His name is Dr. Aksade. He has good reviews on OH. He is practicing general surgery here. How likely is it that I could get a combo surgery from him-- hernia repair, panniculectomy and wound closure all at the same time. Is this even feasible? What do I ask or say to convince him?

Wow. I am sorry you are having so many issues. I have no idea if all of this can be done at once. Can you find another surgeon to get a second opinion? Or even a third?? Sounds like you need to get this done and get it done right.

Where do you live? I had a hernia repair by my plastic surgeon who is also board certified in general surgery. I am in Philadelphia. His name is Stephen Kovach. If you are not around this area perhaps you could find someone with these credentials in your area.

I sent you a private message.
Mikimi in Israel

I saw the surgeon and there is no way to do what I had imagined. I have to heal the wound first, then lap for the hernia unless there is some kind of emergency. Then I can think about a panni.

I had a pretty big hernia, had it repaired open with a panniculectomy. WLS did the hernia repair, then PS came in and did panni. WLS warned me that because the surgery was open she would not use mesh for the hernia, it would be higher risk of infection...and that due to the size of the hernia I had risk of it reoccuring...it did and about a year later she did a lap hernia repair with mesh. So as frustrating as it might be not to have it all done at once, it is probably for the best..