Surgical Management of Spigelian Hernia in Patients with High BMI
Pre-operative Considerations
- The American College of Rheumatology and American Association of Hip and Knee Surgeons conditionally recommend proceeding with surgical intervention without delaying for weight reduction in patients with BMI 35 1, 2, 3
- Postponing necessary surgery for weight reduction may not improve outcomes in patients with high BMI 2
- Patients with high BMI should be informed of the potential increased risks associated with surgery at their current weight 2
- Comprehensive evaluation to identify and optimize any obesity-related comorbidities is necessary before surgery 5
- If the patient has poorly controlled diabetes mellitus, consider delaying surgery to improve glycemic control 1, 3
- If the patient has nicotine dependence, consider delaying surgery for nicotine cessation 1, 3
Post-operative Management
- Patients should be counseled on the potential benefits of weight reduction prior to surgery, even if surgery is not delayed 2
- Encourage continued weight management efforts post-operatively 5
Potential Complications
- Infection is a potential complication of spigelian hernia repair 2