Preoperative Optimization and Enhanced Recovery After Surgery Protocols in Ventral Hernia Repair

Large or complex ventral hernias remain a challenging endeavor with potential for high rates of morbidity. Minimally invasive surgery (MIS) techniques such as laparoscopic and robotic-assisted repairs provide a way to minimize wound morbidity as well as decrease length of hospitalization. Even with the benefits of MIS repairs, complex hernias still present challenges that can be positively affected by optimizing the patient in the preoperative period and standardizing their postoperative care. In an effort to optimize outcomes, pre- and perioperative management strategies have been developed to reduce patient complications, in addition to reducing hernia recurrence. While technical factors for ventral hernia repair (VHR) such as surgical technique and mesh selection are modifiable factors during the operation itself, optimizing the patient prior to surgery and immediately following VHR can provide substantial benefit to the patient with the ultimate goal of providing a safe and durable hernia repair.