Comparing Intensive Weight Loss Program to Immediate Surgery for Adults with Abdominal Wall Hernia and High BMI

What this Trial Is About

Researchers are evaluating whether preoperative intensive weight management is as effective as upfront surgery for obese patients undergoing complex abdominal wall reconstruction. This randomized controlled trial aims to compare abdominal wall-specific quality of life one year after surgery between patients who receive a 6-month medical weight loss program before surgery and those who proceed directly to surgery. The study focuses on adults with abdominal wall hernias and obesity, assessing quality of life using the HerQLes survey. The trial has two groups one receives an intensive 6-month medical weight loss program led by obesity medicine specialists, including monthly visits with providers and dietitians, lifestyle changes, and possible anti-obesity medications tailored to the patient. The other group undergoes upfront open retromuscular ventral hernia repair without required preoperative weight loss. Surgery is performed by specialized hernia surgeons. Medication choices and diet plans are personalized based on health status and preferences. Participants will be involved in monthly visits during the weight management phase to monitor weight, vital signs, and adjust treatments. Researchers will assess quality of life related to abdominal core health at one year as the primary outcome, along with secondary outcomes such as hernia recurrence, wound complications, body composition changes, pain scores, and program adherence. Safety, cost effectiveness, and surgical outcomes will also be tracked. Total participation includes the preoperative period and one year of follow-up after surgery.

Preoperative Weight Loss for Open Abdominal Wall Reconstruction