Body mass index (BMI) thresholds are utilized as a preoperative optimization strategy for obese patients prior to elective abdominal wall hernia repair, with higher BMI associated with increased morbidity and hernia recurrence. In recent years, with the growth of minimally invasive techniques, prehabilitation tools, and advances in mesh technology, postoperative outcomes have significantly improved in this patient population. Data suggest that two-thirds of patients initially presenting in an emergent fashion, whose operation is deferred in attempts to preoperatively optimize them with weight loss strategies, fail to undergo surgery, with those presenting in an emergent fashion having worse outcomes.

Postoperative outcomes in correlation with obesity, technique, timing of surgery, mesh selection and defect size within obese patients are not well understood due to the heterogeneity in which these variables are studied, opening an important topic of discussion regarding the optimal technique and acceptable BMI at which these patients should be intervened upon to yield the optimal short and long-term outcomes with minimal morbidity. The introduction of novel GLP-1 agonists for prehabilitation is also changing the surgical landscape for these patients, and data on this topic are limited.

The scope of this Special Issue is to evaluate outcomes within this population in regards to prehabilitation strategies, techniques, mesh selection, long-term and short term follow up evaluating hernia recurrence, early and late complications as well as Patient reported outcomes.

We invite experimental studies, observational studies, systematic reviews, qualitative and descriptive studies not including case reports for this issue.

Suggested topics:

-Prehabilitation
-GLP1 Agonists/Metabolic Surgery/Lifestyle modifications and diet
-Open vs MIS hernia repair
-Primary repair vs mesh based repairs
-Permanent vs absorbable or biologic mesh
-Inguinal hernia repair
-Patient reported outcomes following hernia repair
-Outcomes in emergency settings

Authors

Journal of Abdominal Wall Surgery