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

Area of Science:

• Abdominal Wall Surgery
• Minimally Invasive Surgery
• Hernia Repair

Background:

• Obesity is a significant risk factor for abdominal wall hernias.
• Obesity is associated with increased postoperative complications and hernia recurrence.
• Treating incisional hernias in obese patients presents unique challenges.

Purpose of the Study:

• To evaluate the safety and efficacy of the extended totally extraperitoneal (eTep) pathway for incisional hernia repair in patients with and without obesity.
• To compare postoperative complications, recurrence rates, and hospital stay between obese and non-obese patients undergoing eTep hernia repair.

Main Methods:

• A prospective, comparative study involving 74 patients undergoing primary ventral or incisional hernia surgery.
• Patients were stratified into two groups based on body mass index (BMI): ≤30 (no obesity) and >30 (obesity).
• Data collected included demographic information, surgical variables, complication rates, recurrence, hospital stay, and follow-up data.

Main Results:

• The median hernia defect size was significantly larger in obese patients (93 cm²) compared to non-obese patients (57 cm²).
• Postoperative complications occurred in one non-obese patient versus four obese patients (p > 0.05).
• No significant differences were observed in recurrence rates, hospital stay, or postoperative pain between the groups.

Conclusions:

• The extended totally extraperitoneal approach is a safe and effective minimally invasive option for incisional hernia repair in patients with obesity.
• Despite larger defect sizes in obese patients, outcomes were comparable to non-obese patients.
• Further studies with larger cohorts and longer follow-up are warranted to confirm these findings.