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. 2022 Mar;36(3):2032-2041.
doi: 10.1007/s00464-021-08489-9. Epub 2021 May 4.

Laparoscopic ventral hernia repair in patients with obesity: should we be scared of body mass index?

Marianna Maspero  1   2 , Camillo Leonardo Bertoglio  3 , Lorenzo Morini  3 , Bruno Alampi  3 , Michele Mazzola  3 , Valerio Girardi  3 , Andrea Zironda  3   4 , Gisella Barone  3 , Carmelo Magistro  3 , Giovanni Ferrari  3
Affiliations

Laparoscopic ventral hernia repair in patients with obesity: should we be scared of body mass index?

Marianna Maspero et al. Surg Endosc. 2022 Mar.

Abstract

Background: Obesity is a risk factor for ventral hernia development and affects up to 60% of patients undergoing ventral hernia repair. It is also associated with a higher rate of surgical site occurrences and an increased risk of recurrence after ventral hernia repair, but data is lacking on the differences between obesity classes.

Methods: Between 2008 and 2018, 322 patients with obesity underwent laparoscopic ventral hernia repair in our department: class I n = 231 (72%), II n = 55 (17%), III n = 36 (11%). We compared short and long-term outcomes between the three classes.

Results: Patients with class III obesity had a longer median length of hospital stay compared to I and II (5 days versus 4 days in the other groups, p = 0.0006), but without differences in postoperative complications or surgical site occurrences. After a median follow up of 49 months, there were no significant differences in the incidence of seroma, recurrence, chronic pain, pseudorecurrence and port-site hernia. At multivariate analysis, risk factors for recurrence were presence of a lateral defect and previous hernia repair; risk factors for seroma were immunosuppression, defect > 15 cm and more than one previous hernia repair; the only risk factor for postoperative complications was chronic obstructive pulmonary disease.

Conclusion: Class III obesity is associated with longer length of hospital stay after laparoscopic ventral hernia repair, but without differences in postoperative complications and long-term outcomes compared with class I and class II obesity.

Keywords: Body mass index; Laparoscopic ventral hernia repair; Obesity; Ventral hernia.

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Conflict of interest statement

Drs. Maspero Marianna, Bertoglio Camillo Leonardo, Morini Lorenzo, Alampi Bruno, Mazzola Michele, Girardi Valerio, Zironda Andrea, Barone Gisella, Magistro Carmelo and Ferrari Giovanni have no conflicts of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
Kaplan Meier curve of hernia recurrence in Obesity Class I (OC1), II (OC2) and III (OC3) patients
See this image and copyright information in PMC

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