Outcome of laparoscopic ventral hernia repair in morbidly obese patients with a body mass index exceeding 35 kg/m2

Abstract

For morbidly obese patients, LVHR is safe and effective, but it is associated with higher likelihood of recurrence, and patients should be appropriately informed.

Open label, prospective, randomized controlled trial of an endoscopic duodenal-jejunal bypass sleeve versus low calorie diet for pre-operative weight loss in bariatric surgery

“…It is reported that even a modest 10% reduction of excess body weight before elective surgery significantly reduces obesity-related risks associated with anesthesia, pulmonary dysfunction, diabetes and hypertension, and other comorbid physiologic conditions [10]. These concepts have been so well established that overweight, obesity, and morbid obesity are now relative contraindications to such procedures as hernia repair, joint replacement, and organ transplantation [1][2][3][4][5].…”

“…Studies show that excess weight and all spectrums of obesity complicate the shortand long-term outcomes of surgical interventions in a variety of ways [1][2][3][4][5][6][7][8][9]. It is reported that even a modest 10% reduction of excess body weight before elective surgery significantly reduces obesity-related risks associated with anesthesia, pulmonary dysfunction, diabetes and hypertension, and other comorbid physiologic conditions [10].…”

Laparoscopic approach to acute abdomen from the Consensus Development Conference of the Società Italiana di Chirurgia Endoscopica e nuove tecnologie (SICE), Associazione Chirurghi Ospedalieri Italiani (ACOI), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia d’Urgenza e del Trauma (SICUT), Società Italiana di Chirurgia nell’Ospedalità Privata (SICOP), and the European Association for Endoscopic Surgery (EAES)

“…• Morbid obesity [324], old age, and debilitation are not considered contraindications to laparoscopy (LE 4) [321,325].…”

The Effect of Obesity on Outcomes of Ventral Hernia Repair: A Propensity Score Matching Analysis

“…While some of these studies looked at outcomes such as length of stay and recurrence, others investigated metrics related to quality of care such as postoperative wound complications. However, specific limitations such as using patients from a single institution (n < 150) and excluding obese patients with BMI's between 25-35 [11,12] contribute to some uncertainty in these studies findings. Furthermore, even though the remaining studies used larger databases, they either included inguinal hernias in addition to ventral hernias [10] or only looked VHR procedures from 2009-2012 in the context of open versus laparoscopic repair.…”

“…A number of recent studies have found an association between obesity and post-operative complications after ventral hernia repair [9][10][11][12]. While some of these studies looked at outcomes such as length of stay and recurrence, others investigated metrics related to quality of care such as postoperative wound complications.…”