ArticleBJS open2021
Perioperative optimization in complex abdominal wall hernias: Delphi consensus statement.
Article in BJS open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 34 citations in OpenAlex.
- Practices in prehabilitation and follow-up after hernia surgery: a global survey of 135 surgeons from 20 countries.Surgical endoscopy · 2026Article
- The Importance of Plastic Surgery in Multidisciplinary Teams: A Systematic Review and Meta-analysis of Comparative Studies.Plastic and reconstructive surgery. Global open · 2026Article
- Patients With Severe Obesity Are Made Eligible for Complex Abdominal Wall Repair After Preoptimization With GLP-1 Agonists: Results of a Bicentric Pilot Study.World journal of surgery · 2025Article
- Development and Validation of a Machine Learning Prediction Model for Textbook Outcome in Liver Surgery: Results From a Multicenter, International Cohort.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Article
- Complex abdomen: a scoping review.Hernia : the journal of hernias and abdominal wall surgery · 2025Article
- Impact of glucagon-Like peptide-1 agonists in optimizing abdominal wall Reconstruction patients.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Obesity increases the surgical complexity and risk of recurrence after midline primary ventral hernia repair: results on 2307 patients from the French Society of hernia surgery (SFCP-CH) registry database.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- The modified frailty index predicts postoperative morbidity in elective hernia repair patients: analysis of the national inpatient sample 2015-2019.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- An established abdominal wall multidisciplinary team improves patient care and aids surgical decision making with complex ventral hernia patients.Annals of the Royal College of Surgeons of England · 2024Article
- Risk factors for reoperation following inguinal hernia repair: results from a cohort of patients from an integrated healthcare system.Hernia : the journal of hernias and abdominal wall surgery · 2023Article
- Midline incisional hernia guidelines: the European Hernia Society.The British journal of surgery · 2023Article
- The influence of a multidisciplinary team meeting and prehabilitation on complex abdominal wall hernia repair outcomes.Hernia : the journal of hernias and abdominal wall surgery · 2023Article
- Impact of a multidisciplinary team discussion on planned ICU admissions after complex abdominal wall reconstruction.Hernia : the journal of hernias and abdominal wall surgery · 2023Article
- The European Hernia Society Prehabilitation Project: A Systematic Review of Intra-Operative Prevention Strategies for Surgical Site Occurrences in Ventral Hernia Surgery.Frontiers in surgery · 2022Review
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe incidence of incisional hernia after major abdominal surgery via a midline laparotomy is 20-41 per cent with short-term follow-up, and over 50 per cent in those surviving an abdominal catastrophe. Abdominal wall reconstruction (AWR) requires complex operations, often involving mesh resection, management of scarred skin, fistula takedown, component separation or flap reconstruction. Patients tend to have more complex conditions, with multiple co-morbidities predisposing them to a vicious cycle of complications and, subsequently, hernia recurrence. Currently there appears to be variance in perioperative practice and minimal guidance globally. The aim of this Delphi consensus was to provide a clear benchmark of care for the preoperative assessment and perioperative optimization of patients undergoing AWR.
methodsThe Delphi method was used to achieve consensus from invited experts in the field of AWR. Thirty-two hernia surgeons from recognized hernia societies globally took part. The process included two rounds of anonymous web-based voting with response analysis and formal feedback, concluding with a live round of voting followed by discussion at an international conference. Consensus for a strong recommendation was achieved with 80 per cent agreement, and a weak recommendation with 75 per cent agreement.
resultsConsensus was obtained on 52 statements including surgical assessment, preoperative assessment, perioperative optimization, multidisciplinary team and decision-making, and quality-of-life assessment. Forty-six achieved over 80 per cent agreement; 14 statements achieved over 95 per cent agreement.
conclusionClear consensus recommendations from a global group of experts in the AWR field are presented in this study. These should be used as a baseline for surgeons and centres managing abdominal wall hernias and performing complex AWR.
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