{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:20:44Z","timestamp":1791822044871,"version":"4.3.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T00:00:00Z","timestamp":1714089600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine outcomes after on lay large ventral hernia repair in obese patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Large ventral hernia repairs (VHR) in obese patients remain a challenge. Obesity is a risk factor for intraoperative difficulties and postoperative complications. Recurrence rates after VHR in obese patients range between 12-50% versus 10% in nonobese patients. While results of laparoscopic techniques in VHR compare favorably to open, outcomes in correlation with obesity, technique, and defect size are less understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single surgeon\u2019s experience of 329 consecutive VHR between 2013-2022 was retrospectively reviewed. Inclusion criteria were obesity (BMI &gt;30) and large hernia defects (&gt;5\u00a0cm). A modified onlay technique was used which included component release and a lightweight monofilament polypropylene mesh. Primary outcome measures were hernia recurrence and wound complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 56 patients met inclusion criteria. Patients were majority male (n=30, 54%), with a median age of 58.5\u00a0years (inter quartile range (IQR) 33-83), and median BMI of 36\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (IQR: 30-72). Median hernia defect size was 8\u00a0cm (IQR: 5-15). Twenty patients had undergone prior mesh repairs. Median follow-up was 52 months (IQR: 6\u00a0months-9\u00a0years). Two patients experienced recurrence (3.6%) and four experienced wound complications (four seromas, one panniculitis, 8.9%). No patients suffered flap ischemia or necrosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Obesity is a risk factor for poor outcomes after VHR. We developed a protocol for obese patients with large defects involving a modified onlay technique which demonstrates comparable results to other VHR techniques in obese patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348241241706","type":"journal-article","created":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T02:29:57Z","timestamp":1714184997000},"page":"2740-2744","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Descriptive Analysis of Outcomes After Onlay Ventral Hernia Repair in Obese Patients"],"prefix":"10.1177","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0794-5790","authenticated-orcid":false,"given":"Carolyn P.","family":"Smullin","sequence":"first","affiliation":[{"name":"Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rivfka S.","family":"Shenoy","sequence":"additional","affiliation":[{"name":"Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin J.","family":"Blair","sequence":"additional","affiliation":[{"name":"Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles F.","family":"Chandler","sequence":"additional","affiliation":[{"name":"Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,4,26]]},"reference":[{"key":"bibr1-00031348241241706","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200301000-00018"},{"key":"bibr2-00031348241241706","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-022-02707-6"},{"key":"bibr3-00031348241241706","unstructured":"Itani KM IncisionalHernia. In: Schumpelick V, Fitzgibbons RJ, eds. Recurrent Hernia: Prevention and Treatment. 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