Observational studyHernia : the journal of hernias and abdominal wall surgery2025
What is the preferred mesh placement in primary ventral hernia repair? An international survey of 442 surgeons.
Observational study 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 5 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association Between Mesh Placement and Recurrence and Chronic Pain After Incisional Hernia Repair: A Systematic Review and Network Meta-Analysis.World journal of surgery · 2026Pooled it
- Mesh placement and risk of reoperation for recurrence after incisional hernia repair. Authors reply.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Mesh placement and patient-reported outcomes in primary ventral hernia repair: a nationwide survey- and register-based study.Surgical endoscopy · 2026Article
- Mesh placement and risk of reoperation for recurrence after incisional hernia repair: a nationwide register-based cohort study.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Trends in mesh placement in elective ventral hernia repair: an 18-year nationwide register-based study.Hernia : the journal of hernias and abdominal wall surgery · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePrimary ventral hernia repair is a common elective procedure; however, mesh placement practices vary widely, and there is limited evidence to guide optimal placement. This international study examined surgeons' preferences and considerations regarding mesh placement in elective primary ventral hernia repair.
methodsWe conducted an international cross-sectional survey targeting surgeons experienced in primary ventral hernia repair. The survey was distributed through hernia societies and social media platforms. It included 31 questions addressing surgeon demographics and their beliefs on various mesh placements. Data were collected using REDCap, Google Forms, and Questionstar.
resultsA total of 442 surgeons participated, with the majority being specialist surgeons (96%) who had performed at least 100 repairs (82%). Inlay was the least familiar mesh technique (26%). For hernia defects < 1 cm, preperitoneal (28%) and suture-only repair (27%) were considered to yield the best overall outcomes. For defects ≥ 1 to ≤ 4 cm, preperitoneal and retromuscular techniques were equally favored (34%), whereas retromuscular was regarded as the best option for larger defects (> 4 to 9 cm; 68%). Laparoscopic and robotic-assisted approaches were increasingly preferred for larger defect sizes. Hernia defect size (93%), surgical history (90%), and obesity (80%) were the most common factors influencing the choice of mesh placement.
conclusionPreperitoneal and suture-only repairs were most commonly selected for hernia defects < 1 cm, while preperitoneal and retromuscular placements were equally favored for defects ≥ 1 to ≤ 4 cm. For defects > 4 to 9 cm, retromuscular placement was selected by most surgeons. As defect width increased, laparoscopic and robot-assisted approaches gained preference. Key factors influencing decisions included hernia defect size, surgical history, and obesity. The lack of strong supporting evidence highlights the need for further high-quality research.
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