ArticleHernia : the journal of hernias and abdominal wall surgery2025
Abandoning mesh "overlap" in favor of "width" and its importance in open retromuscular midline incisional hernia repair: a nationwide database study.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Enhanced view/extended totally extraperitoneal plasty (eTEP) Rives-Stoppa repair versus open Rives-Stoppa repair: a single-center retrospective propensity score-matched cohort study.Surgical endoscopy · 2026Article
- Intraoperative Fascial Traction - From Concept to Comprehensive Application.Journal of abdominal wall surgery : JAWS · 2026Review
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Abstract
purposeRecurrence after open incisional hernia repair remains an issue. Where the mesh preferably is placed in a retrorectus position, it is undetermined what the optimal mesh overlap is. This study aimed to assess the effect of mesh width on long-term recurrence after open incisional hernia repair.
methodThe Danish Ventral Hernia Database was merged with The Danish National Patients Registry allowing a 100% follow-up. From 2011 to 2023 we included patients who underwent elective incisional hernia repair with vertical incision, retromuscular mesh placement, and linea alba reconstruction. Mesh and hernia size and repair type were registered. Kaplan-Meier plots showed cumulative incidences of operation for hernia recurrence over a 5-year period. Possible confounders were included in Cox proportional hazard and logistic regression analyses.
resultsWe included 1,539 patients. Mean (sd) age was 61.2 (12.4) years, 46.2% were females. Mean horizontal defect size was 8.4 (4.2) cm. Seventy-two (4.7%) patients underwent reoperation within 90 days and 112 (7.3%) developed recurrence (median follow-up 3.8 (IQR 1.8-6.1) years). Mesh width of 10-15 cm was associated with significantly decreased risk of operation for recurrence compared to both smaller and larger sizes (HR 0.38, CI 0.16-0.90, P = 0.029). Interestingly, fascial defect width was not associated with recurrence risk when adjusting for mesh width.
conclusionA 10-15 cm mesh width is associated with lower risk of recurrence for patients undergoing elective open midline retromuscular incisional hernia repair: this "golden mean" should be of aim rather than "too little" or "as much as possible".
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