Abstract
Introduction Preoperative rehabilitation programs may improve surgical outcomes. As postoperative weight gain is a risk factor for hernia recurrence, we aimed to evaluate the impact of a weight loss program on preoperative body mass index (BMI) reduction and surgical decision-making. Methods Patients with ventral hernia enrolled in the weight loss program between 2021 and 2023 were retrospectively assessed. Patients with early follow-up loss were excluded. Demographic and clinical data were collected. Weight was assessed at initial visit, preoperatively, postoperatively, and at last follow-up. Our protocol focuses on weight loss, smoking cessation, diabetes optimization, and services such as Botulinum toxin injection and physical therapy for abdominal strength. Statistical analyses were performed using R. Results Of 578 patients, 165 (28.5%) entered the program; 109 met inclusion criteria (53% female; mean age 59 +/- 11 years). Median prehabilitation duration was 104 days with three clinic visits. Median weight and BMI reductions were - 5 kg and - 1.9 kg/m & sup2;, respectively. Recurrent hernia was associated with greater preoperative weight loss, while residence in socioeconomically distressed communities was associated with weight gain. 59 patients (54.1%) underwent surgery and had lower final BMI and greater weight loss (p < 0.001). Surgical completion was less likely among non-White patients. Most underwent robotic repair (85%), and no major complications or recurrences occurred. Pre- and postoperative weight changes were not correlated. Conclusion Our prehabilitation demonstrated meaningful BMI reduction and low postoperative morbidity in patients who engaged in the program. While prehabilitation might reduce recurrence risk, larger randomized and group-controlled studies are needed to confirm long-term benefits.