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Body Mass Index impact on Extended Total Extraperitoneal Ventral Hernia Repair: a comparative study

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Abstract

Purpose

Obesity is a risk factor for developing abdominal wall hernias and is associated with major postoperative complications, such as surgical site infection, delayed wound healing and recurrent hernia. Therefore, treating incisional hernia in this patient subgroup is a challenge.

Methods

We conducted a comparative, prospective study on patients who underwent primary ventral hernia surgery or incisional hernia surgery through the extended totally extraperitoneal pathway, with body mass indices (BMIs) ≤ 30 (no obesity) and BMI > 30 (with obesity). We collected demographic data, preoperative and intraoperative variables, complication and recurrence rate, hospital stay and follow-up as postoperative data.

Results

From May 2018 to December 2020, 74 patients underwent this surgery, 38 patients without obesity and 36 with obesity. The median area of the hernia defect measured by CT was 57 cm2 and 93 cm2 in patients without and with obesity, respectively (p = 0.012). The median follow-up was 16 months. One patient without obesity experienced some postoperative complication compared with four patients with obesity (p > 0.05). No patient without obesity had recurrent hernia compared with two patients with obesity (p > 0.05).

Conclusions

There were statistically significant differences between patients with and without obesity in the size of the hernia defect. However, there were no significant differences in terms of complications, hospital stay, postoperative pain or relapses. Therefore, the minimally invasive completely extraperitoneal approach for patients with obesity appears to be a safe procedure despite our study limitations. Studies with longer follow-ups and a greater number of patients are needed.

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Funding

The authors declare that they have no financial ties to disclose.

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Authors and Affiliations

  1. Endocrine, Breast and Minimally Invasive Abdominal Wall Surgery Unit, General Surgery Department, Fundación Jiménez Díaz University Hospital, Avenida de los Reyes Católicos, 2, 28040, Madrid, Spain

    C. Sánchez García, I. Osorio, P. Villarejo & S. Salido

  2. Endocrine, Breast and Minimally Invasive Abdominal Wall Surgery Unit, General Surgery Department, Villalba General Hospital, Madrid, Spain

    J. Bernar & M. Fraile

Authors
  1. C. Sánchez García
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  2. I. Osorio
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  3. J. Bernar
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  4. M. Fraile
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  5. P. Villarejo
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  6. S. Salido
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Corresponding author

Correspondence to C. Sánchez García.

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For this type of study, ethical approval is not required.

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All procedures performed in this study involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any study with animals performed by any of the authors.

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Informed consent was obtained from all individual participants of the study.

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Sánchez García, C., Osorio, I., Bernar, J. et al. Body Mass Index impact on Extended Total Extraperitoneal Ventral Hernia Repair: a comparative study. Hernia 26, 1605–1610 (2022). https://doi.org/10.1007/s10029-022-02581-2

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  • DOI: https://doi.org/10.1007/s10029-022-02581-2

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