Obesity and laparoscopic repair of ventral hernias

• Published in: Surgical endoscopy Vol. 15; no. 12; pp. 1419 - 1422
• Main Authors: BIRGISSON, G, PARK, A. E, MASTRANGELO, M. J, WITZKE, D. B, CHU, U. B
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 01.12.2001; Springer Nature B.V
• Subjects: Abdomen; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Body Mass Index; Cellulitis - etiology; Female; Follow-Up Studies; Hernia, Ventral - surgery; Humans; Intestines - injuries; Intestines - surgery; Intraoperative Complications - etiology; Laparoscopy - adverse effects; Laparoscopy - methods; Length of Stay; Male; Medical sciences; Middle Aged; Obesity - surgery; Obesity, Morbid - surgery; Postoperative Complications - etiology; Postoperative Complications - surgery; Prospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Human; Obesity; Nutrition disorder; Laparoscopic surgery; Long term; Morbidity; Abdomen; Hernia; Association; Follow up study; Abdominal disease; Surgery; Feasibility; Endoscopy; Technique; Nutritional status
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s004640080077

Laparoscopic ventral hernia repair (LVHR) is gaining acceptance and compares favorably with open repair. Patients who are morbidly obese (MO) traditionally have been considered poor surgical candidates for ventral hernia repair because of their associated comorbidities and risk of postoperative wound infection and hernia recurrence. In this study we evaluated our experience with LVHR in patients who are obese and those who are morbidly obese. All 64 patients undergoing LVHR at the University of Kentucky between September 1997 and October 2000, representing 66 hernias, were entered prospectively into a database. Data before, during, and after surgery were collected as well as follow-up data. Patients were divided into three groups on the basis of body mass index (BMI): normal to overweight (BMI < or = 29); obese (BMI 30-39), and MO (BMI > or = 40). There were 16 patients in the MO group, most of them women. The mean BMI was 43.9 (range, 40-60), and the mean age was 45.6 years (range, 25-68 years). The location of defects was similar among the groups, as were the number of prior repairs. The operative time and length of stay for the MO group tended to be longer than for the other two groups. Five minor complications occurred in the MO group. During a follow-up period ranging from 1 to 35 months, there were no recurrences. Laparoscopic repair of ventral hernias in patients who are morbidly obese is both safe and feasible, and can be performed with minimal morbidity. At this writing, there have been no recurrences, but long-term follow-up evaluation is required.