Visceral obesity ups incisional hernia risk after single-port laparoscopic gynaecologic surgery

In women who had undergone single-point laparoscopic surgery (SPLS) for gynaecological disease, high visceral fat area (VFA) appears to aggravate the risk of incisional hernia (IH), reports a recent study.

The study included 2,116 patients whose background and operative data were retrieved from their medical records. Of the participants, 21 (1.0 percent) developed postoperative IH needing surgical intervention, 18 of whom had available computed tomography images. A control group of 72 randomly selected non-IH participants was also assessed.

Compared with controls, IH patients saw a significantly higher rate of dyslipidaemia (33.3 percent vs 9.7 percent; p=0.02) and higher VFA (148.08 vs 92.78 cm²; p=0.001). Both groups had comparable subcutaneous fat area, operation time, and estimated blood loss.

Receiver operating characteristic curve analysis revealed that at an optimal cutoff value of 136.523 cm², VFA was the strongest predictor of IH, with an area under the curve of 0.749 (95 percent confidence interval [CI], 0.630–0.869; p=0.001).

Other anthropometric and abdominal fat distribution parameters, including body mass index, waist circumference, and total fat area, were likewise significant, but were of lower predictive value.

Meanwhile, multivariate analysis found that only high VFA was a significant correlate of IH risk (hazard ratio, 6.18, 95 percent CI, 1.13-33.87; p=0.04). Other such measures fell short of statistical significance.