Incisional hernia rates following midline laparotomy in the obese patient: a retrospective review

Purpose Incisional hernia is the most common complication of midline laparotomy. Although obesity is a known risk factor, the incidence of hernia formation in obese patients is not well defined. We sought to define the rate of incisional hernia formation in obese patients undergoing primary midline...

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Bibliographic Details
Published in:Hernia : the journal of hernias and abdominal wall surgery 2023-06, Vol.27 (3), p.557-563
Main Authors: Wehrle, C. J., Shukla, P., Miller, B. T., Blake, K. E., Prabhu, A. S., Petro, C. C., Krpata, D. M., Beffa, L. R., Tu, C., Rosen, M. J.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Hernia
Hernias
Herniorrhaphy - adverse effects
Humans
Incisional Hernia - epidemiology
Incisional Hernia - etiology
Laparotomy
Laparotomy - adverse effects
Medicine
Medicine & Public Health
Obesity
Obesity - complications
Original Article
Patients
Retrospective Studies
Risk factors
Surgery
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Summary:Purpose Incisional hernia is the most common complication of midline laparotomy. Although obesity is a known risk factor, the incidence of hernia formation in obese patients is not well defined. We sought to define the rate of incisional hernia formation in obese patients undergoing primary midline laparotomy in a large academic medical center. Methods Obese patients (BMI ≥ 30 kg/m 2 ) who underwent an elective or urgent primary midline laparotomy from 2017 to 2021 at our institution were retrospectively identified. A blinded hernia surgeon reviewed imaging to assess for incisional hernia formation, defined as a midline fascial defect with intra-abdominal contents herniated outside of the peritoneal cavity. Results A total of 2241 patients met inclusion criteria. Cross-sectional imaging was available for 914 (41%) of these patients. The median BMI for all patients was 34.3 kg/m 2 (range 30.0–59.1). Median time to follow-up imaging was 316 days (181–957, IQR = 185) for all patients and 316 days (201–903, IQR = 184) for patients with incisional hernia. In total, 474 (51.9%) had radiographic evidence of an incisional hernia. Colorectal and General Surgery demonstrated the highest rate of incisional hernia ( p  
ISSN:1248-9204
1265-4906
1248-9204
DOI:10.1007/s10029-022-02688-6