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AI-Generated response:

How long do ventral hernia repairs last?

Answer generated on June 4, 2024

The AI-generated responses are for illustration purposes only and should not be used for medical purposes.

Ventral hernia repairs can last effectively for several years, but the risk of recurrence increases over time, particularly beyond 5 years.

  • The 5-year recurrence rate after ventral hernia repair can be greater than 40% with mesh and 70% without mesh.[1]

  • Recurrence rates for specific mesh types vary, with a 9.4% recurrence at 104 months reported for polyester mesh.[2]

  • Poly-4-Hydroxybutyrate (P4HB) mesh shows low recurrence rates of about 9% even after it fully resorbs, which is typically beyond 18 months.[3]

  • Absorbable synthetic mesh has shown a recurrence rate of 18% at 72 months.[4]

  • Factors such as mesh type, surgical technique, and patient-specific variables significantly influence the durability and success of ventral hernia repairs.[1-4]

Additional info

The longevity of ventral hernia repairs is influenced by several factors including the type of mesh used, the surgical technique, and patient-specific factors such as the hernia size and location. Polyester mesh, for example, has shown a tendency to stretch and lose elasticity over time, which can contribute to recurrence rates.[2] On the other hand, newer materials like P4HB have demonstrated promising results with low recurrence rates sustained over several years, suggesting that the choice of mesh can significantly impact long-term outcomes.[3] Additionally, the overall approach to hernia repair, including factors like ensuring adequate mesh width and proper fascial closure, plays a critical role in minimizing recurrence.[1] It's important for surgical teams to consider these variables when planning ventral hernia repairs to optimize patient outcomes and reduce the likelihood of recurrence.

References

Reference 1

1.

Bhardwaj P, Huayllani MT, Olson MA, Janis JE. JAMA Surgery. 2024;:2816986. doi:10.1001/jamasurg.2024.0233.

Publish date: March 3, 2024.

Conversely, greater mesh width, myofascial release, and fascial closure had lower odds of recurrence. Hernia type was the most important variable associated with recurrence. Conclusions and Relevance: In this study, the 5-year recurrence rate after ventral hernia repair was greater than 40% and 70% in patients with and without mesh, respectively. Rates of ventral hernia recurrence increased over time, underscoring the importance of close, long-term follow up in this population.

Reference 2

2.

O'Dwyer PJ, Chew C, Qandeel H. Hernia : The Journal of Hernias and Abdominal Wall Surgery. 2022;26(2):489-493. doi:10.1007/s10029-021-02486-6. Copyright License: CC BY

Publish date: April 5, 2022.

BACKGROUND: Repair of a ventral hernia is increasingly being performed by a laparoscopic approach despite lack of good long term follow up data on outcomes. The aim of this study was to examine the long term performance of a polyester mesh and to assess its elastic properties in patients undergoing laparoscopic ventral hernia repair. METHODS: All patients being assessed for a ventral hernia repair between August 2011 and November 2013 were placed on a prospective database. Those undergoing laparoscopic repair with a polyester mesh were seen at clinic at one month and one year, while their electronic records were assessed at 34 months (range 24-48 months) and 104 months (range 92-116 months). In addition, CT scans of the abdomen and... (truncated preview)

Reference 3

3.

Tran DH, Rubarth C, Leeds SG, et al. The Use of Poly-4-Hydroxybutyrate (P4HB, Phasix™) Mesh in Ventral Hernia Repair: A Systematic Review and Meta-Analysis. Hernia : The Journal of Hernias and Abdominal Wall Surgery. 2024;:10.1007/s10029-024-02996-z. doi:10.1007/s10029-024-02996-z.

Publish date: March 4, 2024.

Sub-meta-analysis restricted to studies with follow up > 18 months continues to show low rates of recurrence of 9% (95%CI, 4-17%), SSI of 9% (95%CI, 4-16%), and 31% (95%CI, 23-41%) for any complications. CONCLUSION: Our study demonstrates that the use of P4HB mesh is both safe and effective in ventral hernia repairs. When further analyzed past 18 months, the time where P4HB mesh fully resorbs, the rates of hernia recurrence, SSI, and any complications remain low of upwards of 5 years and comparable to the rates seen in synthetic and biologics in similar patient populations.

Reference 4

4.

Yu JF, Goldblatt HE, Alter-Troilo K, Hetzel E, Goldblatt MI. Surgical Endoscopy. 2022;36(7):5144-5148. doi:10.1007/s00464-021-08885-1.

Publish date: July 5, 2022.

BACKGROUND: There are many materials available for the reinforcement of complex abdominal wall reconstruction, including permanent synthetic, biologic, and absorbable synthetic meshes. The recurrence rate of complex hernia repairs beyond 5 years has not been reported. We hypothesized that the use of absorbable synthetic mesh in clean wounds would yield favorable long-term outcomes. STUDY DESIGN: Patients who underwent open complex ventral hernia repair with clean wounds (CDC class 1) using absorbable synthetic mesh (Bio-A, Gore, Flagstaff, AZ) in the retrorectus position were retrospectively reviewed. Chart review and a validated telephone questionnaire to screen for recurrence were utilized to evaluate and document hernia recurrence. RESULTS: A total of 49 patients were included in this study. Patients were followed for recurrences for... (truncated preview)

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