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A number of candidates of bariatric surgery may have a concomitant ventral hernia. Simultaneous repair of ventral hernia with bariatric surgery remains a subject of controversy in surgical practice. We present a morbid obese patient who underwent single anastomosis sleeve ileal (SASI) bypass while having a ventral hernia. The procedure for the repair of hernia was postponed until after the bariatric surgery was done. The untreated ventral hernia caused bowel incarceration and anastomosis leakage during the postoperative days. So it seems that patients with small size ventral hernia with no intestinal or omental adhesions may benefit from hernia repair at the same time with bariatric surgery, however, in patients with large or complex ventral  hernia and severe bowel  and omental adhesions, it is advisable not to release adhesions and that the hernia repair be carried out  after the patients weight loss is achieved, to prevent iatrogenic bowel injury and minimize the risk of hernia recurrence  and incarceration.

     

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