Evidence map›Paper›PMID 40856867›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2025

Association of mesh weight with adverse outcomes: a cohort study including 123,880 inguinal hernia repairs.

Brandon Cowan, Priscilla H Chan, Sahil S Patel, Heather A Prentice, Kenneth Sucher, Elizabeth W Paxton, Elliott R Brill, Lavina Malhotra, Francisca M Maertens, Gregory M Heitmann and 1 more

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In one paragraph

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 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Brandon CowanUniversity of California San Francisco East Bay Surgery, Oakland, CA, USA.
Priscilla H ChanMedical Device Surveillance and Assessment, Southern California Permanente Medical Group, San Diego, CA, USA.
Sahil S PatelUniversity of California San Francisco East Bay Surgery, Oakland, CA, USA.
Heather A PrenticeMedical Device Surveillance and Assessment, Southern California Permanente Medical Group, San Diego, CA, USA.
Kenneth SucherMedical Device Surveillance and Assessment, Southern California Permanente Medical Group, San Diego, CA, USA.
Elizabeth W PaxtonMedical Device Surveillance and Assessment, Southern California Permanente Medical Group, San Diego, CA, USA.
Elliott R BrillDepartment of General Surgery, The Permanente Medical Group, Santa Clara, CA, USA.
Lavina MalhotraDepartment of General Surgery, The Permanente Medical Group, San Leandro, CA, USA.
Francisca M MaertensDepartment of General Surgery, The Permanente Medical Group, Oakland, CA, USA.
Gregory M HeitmannDepartment of General Surgery, Southern California Permanente Medical Group, Woodland Hills, CA, USA.
Rouzbeh MostaediDepartment of General Surgery, The Permanente Medical Group, Richmond, CA, USA. rouzbeh.mostaedi@kp.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSurgeons lack conclusive evidence to guide mesh choice for inguinal hernia repair. We sought to evaluate risk for recurrence, reoperation, and chronic postoperative inguinal pain (CPIP) compared among different mesh weight classes.

methodsWe conducted a cohort study including 123,880 repairs in adult patients who underwent first elective mesh-based inguinal hernia repair within a US integrated healthcare system (1/2010-6/2023). Mesh weight was categorized into lightweight (LW, < 50 g), medium-weight (MW, 50-90 g), and heavyweight (HW, > 90 g). Recurrence and reoperation during follow-up were primary outcomes while 5-year CPIP was a secondary outcome. Multivariable Cox regression was used to evaluate risk of primary outcomes, while multivariable logistic regression was used to evaluate the secondary outcome; all models included covariate adjustment and stratified by surgery type.

resultsLW, MW, and HW mesh were used in 49.0% (n = 23,685), 3.8% (n = 1,811), and 47.2% (n = 22,815) of minimally invasive (MIS) procedures, respectively; and were used in 55.7% (n = 42,097), 25.4% (n = 19,183), and 18.9% (n = 14,289) of open procedures, respectively. Among MIS repairs, LW mesh was associated with a lower risk of recurrence, reoperation, and CPIP versus HW, and a lower risk of recurrence and reoperation versus MW. Among open repairs, no difference was seen between LW and MW for recurrence, reoperation, and CPIP, while HW had a lower risk for recurrence and reoperation, but a higher likelihood of CPIP compared to LW.

conclusionLW mesh was associated with a long-term advantage with fewer postoperative complications for MIS repair. HW mesh was associated with higher CPIP risk following an open repair.

Indexed as

Hernia, InguinalHerniorrhaphyPostoperative PainSurgical MeshAdultAgedChronic PainCohort StudiesFemaleHumansMaleMiddle AgedRecurrenceReoperationRetrospective StudiesHernia meshHernia recurrenceInguinal herniaMesh weightReoperation

Identifiers

PMID40856867

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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.