Evidence map›Paper›PMID 28594740›Full record

ArticleAnnals of surgery2018

The Importance of Registries in the Postmarketing Surveillance of Surgical Meshes.

Ferdinand Köckerling, Thomas Simon, Martin Hukauf, Achim Hellinger, Rene Fortelny, Wolfgang Reinpold, Reinhard Bittner

Open access · hybridAbstract readMulticenter Study
In one paragraph

Article in Annals of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
53citing papers in PubMed, 1 pooled it
11.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

53 citing papers in PubMed, 1 synthesis or guideline pooled it, 93 citations in OpenAlex.

  1. Pooled it
  2. Trial
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  4. Review
  5. Article
  6. Evaluation of the safety and effectiveness of crural reinforcement with bio-aHernia : the journal of hernias and abdominal wall surgery · 2025
    Article
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  12. Adhesions After Laparoscopic IPOM-How Serious Is the Problem?Journal of abdominal wall surgery : JAWS · 2025
    Review
  13. Article
  14. Simultaneous incisional hernia repair and colorectal surgery: one or two-step procedure?Hernia : the journal of hernias and abdominal wall surgery · 2024
    Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 2 countries.

Ferdinand KöckerlingDepartment of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, Berlin, Germany.
Thomas SimonDepartment of General and Visceral Surgery, GRN-Hospital Weinheim, Röntgenstrasse 1, Weinheim, Germany.
Martin HukaufStatConsult GmbH, Halberstädter Strasse 40 a, Magdeburg, Germany.
Achim HellingerDepartment of General and Visceral Surgery, Medical Campus University of Marburg, Clinic Fulda, Pacelliallee 4, Fulda, Germany.
Rene FortelnyWilhelminen Hospital, Department of General, Visceral and Oncologic Surgery, Montleartstrasse 37, Vienna, Austria.
Wolfgang ReinpoldDepartment of Surgery and Hernia Center, Wilhelmsburg Hospital Gross-Sand, Gross-Sand 3, Hamburg, Germany.
Reinhard BittnerWinghofer Medicum, Hernia Center, Winghofer Strasse 42, Rottenburg am Neckar, Germany.
InfoConsult (Germany) · DETheologische Fakultät Fulda · DEVivantes Klinikum · DEWilhelminen Hospital · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the role of registries in the postmarketing surveillance of surgical meshes.

backgroundTo date, surgical meshes are classified as group II medical devices. Class II devices do not require premarket clearance by clinical studies. Ethicon initiated a voluntary market withdrawal of Physiomesh for laparoscopic use after an analysis of unpublished data from the 2 large independent hernia registries-Herniamed German Registry and Danish Hernia Database. This paper now presents the relevant data from the Herniamed Registry.

methodsThe present analysis compares the prospective perioperative and 1-year follow-up data collected for all patients with incisional hernia who had undergone elective laparoscopic intraperitoneal onlay mesh repair either with Physiomesh (n = 1380) or with other meshes recommended in the guidelines (n = 3834).

resultsPatients with Physiomesh repair had a markedly higher recurrence rate compared with the other recommended meshes (12.0% vs 5.0%; P < 0.001). In the multivariable analysis, the recurrence rate was highly significantly influenced by the mesh type used (P < 0.001). If Physiomesh was used, that led to a highly significant increase in the recurrence rate on 1-year follow-up (odds ratio 2.570, 95% CI 2.057, 3.210). The mesh type used also had a significant influence on chronic pain rates.

conclusionsThe importance of real-world data for postmarketing surveillance of surgical meshes has been demonstrated in this registry-based study. Randomized controlled trials are needed for premarket approval of new devices. The role of sponsorship of device studies by the manufacturing company must be taken into account.

Indexed as

Product Surveillance, PostmarketingRegistriesSurgical MeshAdultAgedDenmarkFemaleFollow-Up StudiesGermanyHerniorrhaphyHumansLaparoscopyMaleMiddle AgedProspective StudiesTreatment Outcome

Identifiers

PMID28594740
PMCPMC6250300
OpenAlexW2622175630

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.