Comparison of short-term outcomes following robotic ventral hernia repair in patients with obesity: a review of 9,742 patients from the Abdominal Core Health Quality Collaborative database

Abstract

Background Despite the paucity of evidence on robotic ventral hernia repair (RVHR) in patients with obesity, the robotic platform is being used more frequently in hernia surgery. The impact of obesity on RVHR outcomes has not been thoroughly studied. Obesity is considered a major risk factor for the development of recurrent ventral hernias and postoperative complications; however, we hypothesize that patients undergoing robotic repairs will have similar complication profiles despite their body mass index (BMI). Study design: We performed a retrospective analysis of patients ages 18–90 years who underwent RVHR between 2013–2023 using data from the Abdominal Core Health Quality Collaborative registry. Preoperative, intraoperative, and postoperative characteristics were compared in non-obese and obese groups, determined using a univariate and logistic regression analysis to compare short-term outcomes. Results The registry identified 9,742 patients; 3,666 were non-obese; 6,076 were classified as obese (BMI > 30 kg/m²). There was an increased odds of surgical site occurrence in patients with obesity, mostly seroma formation; however, obesity was not a significant factor for a complication requiring a procedural intervention after RVHR. In contrast, the hernia-specific quality of life scores significantly improved following surgery for all patients, with those with obesity having more substantial improvement from baseline. Conclusion Obesity does increase the risk of complications following RVHR in a BMI-dependent fashion on sub-analysis; however, the odds of requiring a procedural intervention are not significantly increased by BMI. Patients with obesity have a significant improvement in their quality of life, and RVHR should be carefully considered in this population.