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. 2023 Dec;226(6):896-900.
doi: 10.1016/j.amjsurg.2023.07.044. Epub 2023 Aug 4.

Outcomes of subsequent abdominal operations after an initial ventral hernia repair

Anna Hayden  1 , Samantha Worth  1 , Brittany Kothari  2 , Weston Keller  3 , Emily McGill  2 , Dawn Blackhurst  3 , William S Cobb  4 , Alfredo M Carbonell  4 , Jeremy A Warren  5
Affiliations

Outcomes of subsequent abdominal operations after an initial ventral hernia repair

Anna Hayden et al. Am J Surg. 2023 Dec.

Abstract

Introduction: Nearly 20% of ventral hernia repair (VHR) patients require a subsequent abdominal operation (SAO), and mesh position may impact the complexity and outcome of the SAO.

Methods: Retrospective review of VHR with mesh from 2006 to 2020 from an internal database and the ACHQC. Primary outcomes measured incidence, complexity, and complications of SAO relative to mesh position.

Results: SAO was required in 433 of 2539 (17.1%) patients, totaling 671 operations; 197/893 (22.1%) with intraperitoneal mesh (IPM) and 236/1646 (14.3%) with extraperitoneal mesh (EPM; p ​< ​0.001). SAO was directly related to VHR in 180 (232 total SAOs) and unrelated in 253 (439 total SAOs). There were no significant differences in complications after SAO between IPM and EPM, nor any difference in adhesion complexity.

Conclusion: Incidence of SAO is higher with IPM, but surgical outcomes are similar. Due to the risk of secondary mesh infection with IPM, significantly more of these were removed at the time of SAO.

Keywords: Abdominal wall reconstruction; Mesh; Subsequent abdominal operation; Ventral hernia repair.

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Conflict of interest statement

Declaration of competing interest Drs. Warren and Carbonell have received honoraria from Intuitive for consulting/speaking. Dr. Warren has also received honoraria from Ethicon for consulting/speaking. Dr. Cobb has received honoraria from W.L. Gore for consulting/speaking. The authors used no AI or AI assisted technologies in the writing process. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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