Ventral Hernias and the Super Obese

Mohamed Dahman, MD, Peter Hallowell, MD, Bruce Schirmer, MD. Department of Surgery, University of Virginia Health System, PO Box 800709, Charlottesville, VA 22908, USA

Introduction: Obesity is associated with an increased incidence of a variety of diseases including hernias. Super obese is defined as a BMI>50 kg/m². Very few reports have examined hernia repair outcomes in this challenging patient population.

Methods: We performed a retrospective study from our ventral hernia database for the period 2002-2009. We looked at demographics, ASA class, wound classification, operative time, operative technique, initial vs. recurrent hernias, morbidity, and mortality.

Results: A total of 45 patients were included, with the vast majority (43) being female. Average age was 47.8 + 10.4 (mean + SD). Average BMI was 57.3 + 7. Mean operative time was 1 hour 55 minutes. Regarding wound classification, we had 80.8% clean, 17.8% clean contaminated, 0% contaminated, and 2.2% dirty. ASA class was mainly ASA 2 (26.7%) and ASA 3 (66.7%). We had 33 (73.3%) initial hernia repairs and 12 (26.7%) recurrent cases,. The recurrence rate overall was 8.9%. A laparoscopic approach was used in 28.9% of cases, and an open approach in 71.1%. Overall morbidity for the group was 33.3%. Of these morbidities, there was an 11.1% incidence of wound infection. Seroma formation was 8.9%. Mesh infection was 0%. We had no mortality in this group.

Conclusions: Given the recent increase in the super obese population, a better understanding of the risks and challenges of this group is mandatory. Our study demonstrates the safety and efficacy of ventral hernia repair in the super obese population.

Session: Poster
Program Number: P338
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