Tirzepatide-Based Prehabilitation Before Elective Ventral and Incisional Hernia Repair in Patients With Obesity

This study evaluated whether a 16-week weight-loss program using tirzepatide before elective ventral and incisional hernia surgery could improve surgical readiness and outcomes in patients with obesity. In this retrospective multicenter study, 109 patients entered the program, and 91 completed treatment and underwent surgery. Participants achieved an average weight loss of 13.8%, and all patients who completed the program reached the target weight required for surgery. Compared with a control group of obese patients who underwent hernia repair without pharmacological prehabilitation, the tirzepatide group experienced fewer postoperative wound-related complications.

Inclusion Criteria: * Age ≥ 18 years * Body mass index (BMI) ≥ 30 kg/m² * Elective primary ventral or incisional midline hernia * European Hernia Society (EHS) width W2 (4-10 cm) or W3 (\> 10 cm) * Hernia amenable to a standard Rives-Stoppa retromuscular repair * Able and willing to comply with the prehabilitation program and scheduled follow-up Exclusion Criteria: * Emergency presentation or incarcerated/strangulated hernia * Contraindication to tirzepatide (personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2; prior pancreatitis; severe gastrointestinal disease; pregnancy or lactation) Ongoing treatment with another anti-obesity medication * Prior bariatric surgery within the preceding 12 months * Hernia requiring posterior component separation or transversus abdominis release (TAR) * Inability to comply with follow-up