Trial reportThe British journal of surgery2025
Recurrence rate and mesh bulging are reduced with primary fascial closure in ventral hernia repair: the PROSECO randomized clinical trial.
Trial report in The British journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A Systematic Review and Meta-Analysis of Randomized Controlled Trials on Fascial Defect Closure Versus Bridged Repair in Laparoscopic Ventral Hernia Mesh Repair.World journal of surgery · 2026Pooled it
- Comparison of facial defect closure and non-fascial closure in ventral hernia repair: A systematic review and Meta-analysis of randomized controlled trials with trial sequential analysis.Hernia : the journal of hernias and abdominal wall surgery · 2026Pooled it
- Beyond acronyms: a domain-based structural analysis of abdominal wall hernia repair techniques in the contemporary literature.Surgical endoscopy · 2026Article
- Incisional hernia repair using component separation with perforator preservation and onlay mesh: A pilot study.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- How Reproducible Are Abdominal Wall Surgical Techniques? A Methodological Assessment of Technical Reporting in the Contemporary Literature.Journal of abdominal wall surgery : JAWS · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundLaparoscopic intraperitoneal onlay mesh repair using a bridging technique has shown high rates of hernia site complications. Primary fascial closure before mesh placement has been utilized to address this. This randomized, parallel, double-blind, multicentre controlled trial investigated whether primary fascial closure reduces hernia site complications.
methodsAdults undergoing laparoscopic intraperitoneal onlay mesh repair for a midline hernia were randomized to primary fascial closure or bridging. Clinical assessment and the Ventral Hernia Pain Questionnaire were completed preoperatively and at 3 and 12 months post-surgery. CT scans were performed pre- and 12 months post-surgery. It was hypothesized that non-resorbable suture closure would reduce complication rates from 30% to 13% at 12 months, requiring 180 patients for 80% power and 95% significance.
resultsOne hundred and ninety-two patients were randomized (97 closure, 95 bridging), with 173 (90%) completing 1-year follow-up. At 12 months, overall hernia site complication rates showed no significant difference clinically (18% versus 20%, P = 0.85) or on CT (25% versus 28%, P = 0.50). However, recurrence and mesh bulging were significantly lower with fascial closure (4% versus 20%, P = 0.006). This group also reported significantly less pain at 12 months.
conclusionAlthough there was no difference in the primary endpoint, fascial closure resulted in significantly lower rates of recurrence and mesh bulging, along with reduced postoperative pain. These findings suggest that primary fascial closure should be recommended alongside intraperitoneal onlay mesh repair in midline hernias.
trial registrationThe trial was registered at the ISRCTN at the start of the trial (ISRCTN51495042).
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