Short-term complications after minimally invasive retromuscular ventral hernia repair: no need for preoperative weight loss or smoking cessation?

Purpose: Obesity and smoking are associated with postoperative wound complications following open hernia repair. However, with the advancements in minimally invasive surgical techniques, we hypothesized that obese and/or smoking patients undergoing minimally invasive repairs were not subjected to an increased risk of postoperative surgical complications. As opposed to nonobese and/or nonsmoking patients. Methods: This was a retrospective cohort study including patients undergoing minimally invasive retromuscular repair at a single university hospital. Patients were divided into two groups according to exposure; obese vs. nonobese and smoking vs. nonsmoking. One month postoperatively, all patients underwent clinical follow-up. The main outcome was surgical site occurrence (SSO). Results: A total of 94 patients were included, undergoing both laparoscopic (n = 32) and robotic (n = 62) retromuscular repair. Of these, 7.7% of the obese patients had SSO when compared with 19.1% of the nonobese patients. A total of 17.2% of the nonsmokers had SSO compared with 13.3% of the active smokers. Of the nonsmokers, 12.5% developed seroma and 6.2% hematoma postoperatively, the corresponding numbers were 13.3% and 0% among the active smokers. After multivariable analysis, there was no significant risk factors for developing postoperative SSO. Conclusion: There was no association between obesity or smoking and surgical complication in patients undergoing minimally invasive retromuscular repair. If the results of the current study are confirmed, patients who are unable to obtain weight loss or smoking cessation may be offered minimally invasive retromuscular ventral hernia repair without inducing an increased risk of short-term complications.