Year of Publication

2016

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Carolyn Williams

Clinical Mentor

Dr. John Scott Roth

Committee Member

Dr. Martha Biddle

Abstract

Surgeons generally agree that morbid obesity is a contraindication to ventral hernia repair surgery due to risk of adverse outcomes. The purpose of this study was to describe the experience of patients with ventral hernia complicated by morbid obesity by reviewing a population of patients that were seen by a surgical service to determine the characteristics of those patients that had favorable and unfavorable outcomes. A retrospective medical record review was conducted of new patients with ventral hernias and morbid obesity (body mass index (BMI ) ≥ 40 kg/m2) seen by one surgical service over a two and a half-year time period. Clinical characteristics were noted, and surgical approach and clinical outcomes were noted for patients that had hernia repair. Patients that did not return were attempted to be contacted for a survey.

A total of 79 new patients with ventral hernias and morbid obesity were seen during the time period described. Eighteen patients did not follow up after initial visit; telephone surveys were conducted with six subjects. Morbidly obese patients with ventral hernias that were amenable to laparoscopic repair had favorable outcomes. Patients that had hernia repair that had met goal weight were few in numbers. Patients that had open hernia repair had increased rate of surgical site issues compared to patients that had laparoscopic repairs. Follow up surveys, because few in number, provided anecdotal information. Further research is needed to understand best practices for patients with ventral hernias complicated by morbid obesity.