Impact of body fat location and volume on incisional hernia development and its outcomes following repair

Abstract

BackgroundObesity is known to increase the likelihood of developing abdominal wall hernias, body mass index (BMI) alone does not provide detailed information about the amount and location of body fat. The aim of this study was to investigate the link between various adipose tissue parameters and the incidence of incisional hernias (IHs), as well as the outcomes of hernia repair.MethodsWe conducted a comprehensive review of the existing literature to examine the relationship between various body fat parameters and the occurrence of IHs after abdominal surgeries, as well as the outcomes of hernia repair.ResultsThirteen studies were included for analysis. Eight trials evaluated the IH development after abdominal surgeries via specific fat parameters, and five studies evaluated the postoperative outcomes after IH repair. The findings of this study suggest that an increase in visceral fat volume (VFA or VFV) and subcutaneous fat (SFA or SFV) are linked to a higher incidence of IHs after abdominal surgeries. Higher levels of VFV or VFA were associated with more challenging fascia closure and greater postoperative recurrence rates following repair. Whereas BMI did not demonstrate a significant association.ConclusionMeasuring visceral and subcutaneous fat composition preoperatively can be a useful tool for assessing the risk of IH, and is more reliable than BMI. Elevated levels of these fat parameters have been linked to increased recurrence of IH following hernia repair, as well as the use of complex surgical techniques during repair.

Occurrence and prevention of incisional hernia following laparoscopic colorectal surgery

“…Early intervention within 6 months postoperatively can enhance IH repair when abdominal wall defects are small[ 27 ]. It is also recommended to stratify the management of obese patients based on BMI, or by measuring the preoperative visceral and subcutaneous fat composition with better predictive ability[ 28 ]. In particular, patients with a BMI ≥ 35.0 kg/m 2 may benefit from weight loss prior to repair surgery to reduce recurrence rates[ 24 , 29 ].…”