"I Just Wish Someone would Take me Very Seriously": Impact of Delayed Ventral Hernia Repair on Patient Wellbeing.

Objective: To explore the impact of delayed or deferred ventral hernia repair for surgical optimization, including consequences on physical, social, and emotional wellbeing.

Background: While previous studies have shown that surgical optimization can reduce complications of ventral hernia repair surgery, many patients face various barriers which preclude them from meeting these requirements, resulting in delayed or deferred surgery. Though these optimization requirements are well intentioned, the unintended consequences on patient wellbeing of needing to live with untreated hernia repairs remains unknown.

Methods: Semi-structured qualitative interviews from January to June 2022 were conducted in a preoperative optimization clinic of 20 participants with ventral wall hernias were analyzed using an inductive thematic approach. The discussions aimed to explore challenges that patients living with untreated hernias faced, and what their expectations were during clinic visits. The transcripts were coded and analyzed using the MAXQDA software.

Results: Our study demonstrated 3 predominant themes in unintended consequences of delaying ventral hernia repair surgery for surgical optimization, including decreased feelings of emotional and social wellbeing, feelings of fear and uncertainty about the future, and frustration with lack of patient autonomy and preferences.

Conclusions: Untreated hernias have many unintended psychosocial consequences that need to be accounted for when determining surgical candidacy, using a shared-decision making approach.