P-148 EFFECT OF MEDICAL AND SURGICAL WEIGHT MANAGEMENT PROGRAMMES FOR PRE-OPERATIVE WEIGHT LOSS PRIOR TO VENTRAL HERNIA REPAIR

Abstract

Abstract Introduction Obesity is a recognised risk factor for perioperative morbidity in patients undergoing complex incisional hernia repair. Weight reduction can reduce risk of perioperative complications. The aim of this study was to assess the effects of the different weight management modalities prior to planned incisional hernia repair upon the Carolinas equation for Determining Associated Risks (CeDAR) score. Method A prospectively maintained database of patients who were referred to the weight management clinic prior to planned incisional hernia repair was reviewed. Patients’ demographics, weight loss outcomes and CeDAR scores were calculated before and after the intervention. Results 9 patients were enrolled onto the weight management programme prior to the planned incisional hernia repair (defect size 4 – 14cm), 3 underwent bariatric surgery whilst 6 had medical weight management in the form of a 12-week pre-operative diet programme. The mean age was 54 ± 9.4 years with a mean weight pre-intervention of 110.5 ± 7.4 kg and the mean BMI was 41.78 ± 1.98 kg/m2. Bariatric surgery was associated with a higher percentage weight loss (22.6%) compared to 12week diet programme (10.4%) with an associated higher reduction of CeDAR score (14% and 4% reduction in risk respectively). Conclusion Formal weight management programmes prior to complex abdominal wall reconstruction leads to clinically significant weight loss with reduced CeDAR score. Patients with raised BMI considering incisional hernia repair should be counselled for this and where possible offered a suitable weight management to reduce peri-operative risk.