Outcomes of subsequent abdominal operations after an initial ventral hernia repair

Anna Hayden; Samantha Worth; Brittany Kothari; Weston Keller; Emily McGill; Dawn Blackhurst; William S Cobb; Alfredo M Carbonell; Jeremy A Warren

doi:10.1016/j.amjsurg.2023.07.044

Outcomes of subsequent abdominal operations after an initial ventral hernia repair

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

Authors

Anna Hayden¹, Samantha Worth¹, Brittany Kothari², Weston Keller³, Emily McGill², Dawn Blackhurst³, William S Cobb⁴, Alfredo M Carbonell⁴, Jeremy A Warren⁵

Affiliations

¹ University of South Carolina School of Medicine Greenville, USA.
² Summer Program for Undergraduate Research in Surgery, Prisma Health Department of Surgery, USA.
³ Prisma Health Department of Surgery, USA.
⁴ University of South Carolina School of Medicine Greenville, Prisma Health Department of Surgery, USA.
⁵ University of South Carolina School of Medicine Greenville, Prisma Health Department of Surgery, USA. Electronic address: Jeremy.warren@prismahealth.org.

PMID: 37633763
DOI: 10.1016/j.amjsurg.2023.07.044

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.

MeSH terms

Hernia, Ventral* / surgery
Herniorrhaphy
Humans
Incidence
Recurrence
Retrospective Studies
Surgical Mesh*
Tissue Adhesions / surgery
Treatment Outcome