Clinical predictors of operative complexity in laparoscopic ventral hernia repair: a prospective study

Background Because of uncertainties about the complexity of laparoscopic ventral hernia repair for varying patient populations, surgeons may be reluctant to perform this procedure. This study aimed to delineate the risk factors that can be identified in the preoperative setting predictive of longer operative times and complexity in laparoscopic ventral hernia repair. Methods Patient demographics including body mass index (BMI), comorbidities, previous laparoscopic and open surgical procedures, ventral hernia repairs, and hernia characteristics (defect size and location, adhesions, incarceration) were recorded prospectively. Data are given as mean ± standard deviation. Times (min) required for abdominal access, adhesiolysis, and mesh placement as well as the total operative time were recorded during each case as outcome measures of operative difficulty. Univariate analyses were performed with the t -test or the Mann–Whitney U test as well as multivariate analyses using the stepwise analysis of covariance model to determine demographic and clinical variables influencing operative times. Result The study enrolled 180 patients (78 men and 102 women) with a mean age of 54.8 ± 12.2 years and a mean BMI of 33.3 ± 13.0 kg/m 2 . Multivariate analysis demonstrated significantly longer ( p