Principal Investigator: Michael Rosen, MD, FACS, Professor of Surgery, Chief of the Division of GI Surgery, Northwestern Medicine, Northwestern University Feinberg School of Medicine

Too much belly fat increases intra-abdominal pressure that puts any obese patient facing abdominal surgery at high risk for an incisional hernia. More than 40% of U.S. adults are obese, which presents a quandary for hernia surgeons. Should they counsel their obese patients to lose weight before surgery to better optimize their outcomes? Or should they recommend upfront surgery to avoid worsening of painful hernia symptoms and the potential need for emergency surgery?

With little supporting evidence, many surgeons defer elective hernia repair in patients with a body mass index (BMI) over 35 to 40 kg/m². As a result, 70% of obese patients who fail to lose enough weight never have surgery and 3 to 5% undergo an emergency hernia repair because of the delay in having surgery. This year, a DHF award is supporting Dr. Rosen’s team in conducting a first-ever clinical trial to evaluate the effectiveness of preoperative weight reduction strategies versus upfront surgery in hopes of improving the counseling and care of obese hernia patients with evidence-based findings.