Potential and feasibility of preoptimisation in ventral hernia repair- a focus group study

The aim of this study was to explore patients' experiences of participation in a preoptimisation programme prior to ventral hernia repair, focusing on the programme's feasibility and patient-perceived potential.

Preoptimisation of modifiable risk factors has received growing attention, but little is known about ventral hernia patients' perspectives on such programmes. Understanding patient motivation and perceived barriers is critical for designing effective interventions.

Eight ventral hernia patients participated in a home-based preoptimisation programme lasting at least three weeks. Focus group interviews were conducted and analysed using reflexive thematic analysis.

Participants generally perceived the preoptimisation programme positively. Clear and structured advice was valued, with participants appreciating straightforward instructions on physical activity and lifestyle change. Reported barriers included everyday life circumstances, orthopaedic comorbidities, and in some cases the hernia itself. Patients described perceived positive health effects, including improved fitness, weight loss, and better diabetes control. No adverse effects were raised during the interviews.

This is, to our knowledge, the first qualitative study of pre-optimisation programmes in ventral hernia surgery. As an exploratory, hypothesis-generating study, its findings are shaped by sample size and setting but provide novel insights that complement quantitative research by highlighting patient perspectives. Pre-optimisation programmes appear feasible and meaningful to ventral hernia patients, particularly when supported by clear guidance, structured follow-up, and surgeon involvement. The findings are discussed in the light of Self-Determination Theory, which emphasises internalisation of motivation through autonomy, competence, and relatedness.