This is not a vanity operation, it's a high-risk operation. This at least allows people who are considering this surgery to go in a little bit more with their eyes open.

That is significantly higher than most people expect when they think of obesity surgery. Patients are at higher risk for having bad things happen after surgery because of their advanced age or other conditions.

This is a major operation in a high-risk population.

This is a reality check for people thinking of having obesity surgery. Patients really need to go into this with their eyes open. This can be a high-risk operation.

If we're going to do this operation at all in patients 65 and older, it should really be done in places that can deliver the lowest risks to the patient.

For years, surgeons have been struggling to find the best way to avoid the greatest harm in patients with incidentally identified hernias. Avoiding harm in this case is easy — it can best be accomplished by counseling and educating patients and only repairing hernias that cause symptoms.