Comparison of laparoscopic and open ventral hernia repair for obese patients.

Open vs. Laparoscopic Ventral Hernia Repair: Which Is Best for Obese Patients?

Kai Mendoza in Health & Wellness December 2025 • 4 min read.

"A comparative analysis of surgical outcomes, costs, and recovery times to help you make an informed decision."

Obesity is a significant health challenge, often increasing the risk of ventral hernias due to increased intra-abdominal pressure. When a hernia does occur, choosing the right repair method is crucial. Traditionally, open surgery has been the standard, but laparoscopic techniques are gaining traction, particularly for obese patients.

Recent research suggests that laparoscopic ventral hernia repair (LVHR) offers several advantages over open ventral hernia repair (OVHR) for individuals with obesity. These benefits typically include shorter hospital stays and potentially reduced postoperative pain. However, questions remain about long-term costs and effectiveness.

This article analyzes a study comparing LVHR and OVHR in obese patients, focusing on key outcomes such as length of stay, hospitalization costs, and operative time. By examining these factors, we aim to provide a clearer picture of which approach may be more beneficial.

What the Research Reveals: A Head-to-Head Comparison

Comparison of laparoscopic and open ventral hernia repair for obese patients.

The study retrospectively reviewed 100 obese patients (BMI > 30kg/m²) who underwent ventral hernia repair between 2014 and 2015. Of these, 11 patients underwent LVHR, while 89 underwent OVHR. Researchers compared demographics, hernia size, operative time, length of stay (LOS), and hospitalization costs (HC) between the two groups.

Here's a breakdown of the key findings:

Patient Selection: The laparoscopic approach was predominantly used for elective surgeries and smaller hernias. Open surgery was more common for larger or emergency cases.
Operative Time: The average operation time was similar between the two groups (approximately 119 minutes).
Length of Stay: Patients who underwent laparoscopic repair experienced a significantly shorter length of stay (2.9 days) compared to those who had open surgery (8.53 days).
Hospitalization Costs: Despite the shorter hospital stay, the overall hospitalization costs were higher for the laparoscopic repair group. This is largely attributed to the use of specialized composite meshes and tackers required for the laparoscopic procedure.
Complications: Wound infections were only observed in the open surgery group.

These results indicate that while laparoscopy offers a faster recovery in terms of hospital stay, the initial costs are higher. However, the lack of wound infections in the laparoscopic group could potentially lead to cost savings in the long run by avoiding readmissions and additional treatments.

Making the Right Choice: Factors to Consider

Choosing between open and laparoscopic ventral hernia repair when you're obese involves weighing several factors. Laparoscopy offers the advantage of a shorter hospital stay and potentially fewer wound infections, which can be particularly appealing. However, the higher initial costs associated with the procedure need to be considered. Ultimately, the best approach depends on individual circumstances, hernia size and location, and your surgeon's expertise. Discussing these factors thoroughly with your surgeon is crucial to making an informed decision that aligns with your health needs and financial considerations.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

Everything You Need To Know

What are the primary differences between Open Ventral Hernia Repair (OVHR) and Laparoscopic Ventral Hernia Repair (LVHR) for obese patients?

The main differences between OVHR and LVHR for obese patients lie in recovery time, hospitalization costs, and the risk of complications. LVHR typically leads to a shorter hospital stay, with the study showing an average of 2.9 days compared to 8.53 days for OVHR. However, LVHR can have higher initial hospitalization costs due to the use of specialized equipment such as composite meshes and tackers. In this study, no wound infections were observed in the LVHR group, while they were present in the OVHR group, which can affect long-term costs. The operative time was similar in both approaches.

How does obesity impact the decision between Open Ventral Hernia Repair and Laparoscopic Ventral Hernia Repair?

Obesity significantly influences the choice between OVHR and LVHR due to the increased risk of ventral hernias caused by higher intra-abdominal pressure. The decision must consider the patient's BMI, hernia size and location. Given the benefits, laparoscopic approaches are favored in obese patients because they can offer advantages such as potentially reduced postoperative pain and shorter hospital stays. Larger hernias or emergency cases might still require open surgery.

What specific factors contributed to the higher hospitalization costs associated with Laparoscopic Ventral Hernia Repair (LVHR)?

The higher hospitalization costs for LVHR are primarily attributed to the use of specialized equipment necessary for the procedure. These include composite meshes and tackers, which are essential for performing the repair laparoscopically. These items are more expensive compared to the materials used in OVHR, contributing to the increased initial costs of LVHR, despite its shorter length of stay.

In the study, what were the key findings regarding operative time and complications when comparing LVHR and OVHR?

The study found that the operative time was similar between LVHR and OVHR, with both groups taking around 119 minutes on average. However, a significant difference was observed in complications. Wound infections were only observed in the OVHR group, while the LVHR group did not experience any wound infections. This difference in complication rates may have long-term implications regarding the overall cost-effectiveness of each approach.

Considering the findings, what factors should obese patients discuss with their surgeon when deciding between LVHR and OVHR?

Obese patients should discuss several key factors with their surgeon. These include the hernia's size and location, the surgeon's expertise in both LVHR and OVHR, and the patient's overall health. Patients should be informed about the shorter hospital stay and potentially reduced risk of wound infections associated with LVHR. They should also be aware of the higher initial costs of LVHR. The patient should also discuss the long-term implications of these differences, such as the potential for fewer readmissions and additional treatments if they undergo LVHR.