Postoperative Outcomes Among Patients Evaluated via Telemedicine-Based Preoperative Consultation for Moderate and Large Ventral Hernia.

Abstract

The rapid integration of telemedicine, accelerated by the COVID-19 pandemic, has become an integral part of perioperative care across various surgical specialties. While its role in routine postoperative care is well established, its application in the initial evaluation of complex conditions, such as moderate-to-large ventral hernia, remains unclear. This study investigates the feasibility and outcomes of telemedicine-based preoperative evaluations for patients presenting with ventral hernia measuring more than 4 cm in width. We conducted a single-center, retrospective cohort study comparing patients with moderate-to-large ventral hernia evaluated through telemedicine-based vs traditional in-person encounters. We analyzed demographic, intraoperative, and postoperative factors. The primary goal was to compare perioperative outcomes between patients evaluated entirely virtually preoperatively and patients who had at least 1 in-person encounter. From January 2021 to November 2024, 478 patients underwent ventral hernia repair, of whom 106 (22%) were evaluated entirely virtually before the day of operation. No difference was observed in perioperative outcomes, including complication rates, length of stay, and recurrence rates. One-year surveillance rates were higher in the cohort that was evaluated preoperatively via entirely virtual encounters (62% vs 44%, p = 0.007). Telemedicine-based preoperative evaluations for moderate-to-large ventral hernia are feasible and safe, with postoperative outcomes comparable with those after traditional in-person new patient consultations. This approach can expand access to specialized care, especially for geographically distant patients. Further prospective studies are needed to refine practices and explore broader applications of telemedicine in complex surgical care.