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Updated: Feb 3, 2026
05:47
Use of a Rat Model to Study Ventral Abdominal Hernia Repair
Published on: October 2, 2017
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Complex Ventral Hernia Repair in the Class III Morbidly Obese Patient
Nicholas C Oleck, Farrah C Liu, Michael Conway1
1Christiana Hernia Center, Newark, DE.
Annals of Plastic Surgery
|October 17, 2018
Summary
Complex ventral hernia repair (VHR) is viable for class III obese patients. Sparing epigastric artery perforators reduced wound complications and reoperations, yielding results comparable to the general population.
Area of Science:
- Surgical innovation in abdominal wall reconstruction.
- Management of complex ventral hernias in obese patients.
Background:
- Obesity (BMI ≥ 40 kg/m²) presents challenges for complex ventral hernia repair (VHR).
- Traditional VHR techniques may exclude patients with class III obesity due to high complication rates.
Purpose of the Study:
- To investigate the efficacy of VHR using epigastric artery perforator sparing incisions, component separation, and retrorectus mesh in class III obese patients.
- To assess the impact of this technique on wound complications and hernia recurrence.
Main Methods:
- Retrospective review of 131 class III obese patients undergoing open VHR from 2010-2017.
- Comparison of outcomes before and after implementing epigastric artery perforator sparing skin incisions in 2013.
Main Results:
- Mean BMI was 46.7 kg/m².
- Post-2013, wound breakdown decreased from 49.0% to 26.3% (P < 0.01).
- Reoperations decreased from 60.8% to 31.3% (P < 0.001).
- Overall recurrence rate was 5.3%; infection rate was 21.4%.
Conclusions:
- Complex VHR with abdominal wall reconstruction is a viable option for class III obese patients.
- Epigastric artery perforator sparing incisions significantly reduce wound complications and reoperations.
- Hernia recurrence and wound complication rates are comparable to the general VHR population.
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