The Impact of the "Slim-Mesh" Technique on Operation Time and Short/Midterm Outcomes in 67 Overweight, Obese and Superobese Patients from a 10-year Follow-up Study.

Abstract

Purpose: We performed the sutureless "Slim-Mesh" laparoscopic procedure to repair ventral hernias in overweight/obese patients in order to decrease operative time and complications.

Materials and methods: Between 2009 and November 2018, 67 consecutive overweight/obese patients affected by ventral hernia were operated on at our center with the "Slim-Mesh" technique. This was a prospective (65%)-retrospective study.

Results: Our study included 36 males and 31 females; the patients' mean age was 59 years old and mean BMI 31. There were 28 overweight patients, 28 Class I obese patients, and 11 Class II-III obese and superobese patients. Ventral hernia operative size was 3-10 cm (small/medium ventral hernia), 10-20 cm (large/giant) and ≥20 cm (massive) in 45, 17 and 5 cases respectively. Mean surgical time for overweight patients, Class I obese patients, and Class II-III obese and superobese patients was 95 minutes, 103 minutes, and 103 minutes respectively. In 28.3% of cases, ventral hernia operative size was larger than preoperative size, and in 16.4% laparoscopy detected additional fascial defects. We employed a composite mesh in 91% of patients and absorbable straps for mesh fixation in 85%. Mean length of hospital stay was 2.6 days. Mean follow-up time was more than 3.5 years. There were 3 cases (4.4%) of hernia recurrence.

Conclusion: The sutureless "Slim-Mesh" technique in overweight/obese patients has several advantages, including a reduction in operative time, recovery, and rate of recurrence. The use of this approach would be fast, safe and simple option for overweight/obese patients.