Affiliation:
1. Northern Clinical School, Sydney Medical School The University of Sydney Sydney New South Wales Australia
2. The University of Sydney School of Rural Health Sydney Medical School Sydney New South Wales Australia
3. Upper Gastrointestinal Surgical Unit Royal North Shore Hospital Sydney New South Wales Australia
Abstract
AbstractBackgroundVentral hernia repair is a common elective surgical procedure lacking strong evidence for specific operative approaches. This study aimed to evaluate the outcomes of primary suture repair or polypropylene sandwich mesh repair for ventral hernias. The main outcome measures were the rate of hernia recurrence, and evaluation of long‐term complications and patient‐reported outcomes.MethodsThis retrospective cohort study evaluated patient perceived recurrence and pain in patients who had undergone a primary ventral hernia (epigastric, supraumbilical, or umbilical) repair or small (≤20 mm) midline incisional hernia repair 10 years after the procedure. Short‐term follow‐up occurred up to 6 weeks after the initial operation, while long‐term follow‐up included patients who were reviewed clinically or interviewed via telephone at or beyond 3 years after the procedure.ResultsMost (75/100, 75.0%) patients had an extra‐peritoneal sandwich mesh repair. Short‐term follow‐up showed minimal pain and normal activities for all patients (97/97, 100%). Long‐term follow‐up (median 12 years [IQR 11–13]) was achieved in 95.9% (93/97) of patients with only a small number reporting a slight bulge (5/93, 5.4%) and intermittent mild discomfort (8/93, 8.6%). Nine patients (9/97, 9.3%) experienced hernia recurrence, diagnosed at a median of 26 months [interquartile range, IQR, 7–58] post‐operatively.ConclusionsThese findings suggest that an open sandwich mesh technique is a safe and effective method for repairing primary ventral hernias and small midline incisional hernias and is associated with favourable long‐term patient‐reported outcomes.