ArticleSurgical endoscopy2026
Low long-term decision regret following mesh-based hernia repair: 5-year outcomes in a previously surveyed cohort.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPreoperative concerns about mesh are common, but their relationship to long-term decision regret after hernia repair (HR) remains unclear. We evaluated long-term decision regret (DR) among patients who previously completed a preoperative mesh perception survey followed by mesh-based hernia repair.
methodsPatients who had previously completed a preoperative mesh perception survey and later underwent HR were surveyed to assess DR using the Brehaut Decision Regret Scale (BDRS). The BDRS ranges from 0 (no regret) to 100 (highest regret). Scores ≤ 25 were considered minimal regret, while scores > 25 indicated more than minimal regret. Descriptive analyses were performed.
resultsOf 202 patients in the original survey cohort, 97 (48.0%) underwent HR, and 48 (49.5%) completed the follow-up BDRS survey. Mean age was 58.9 ± 12.8 years, 64.6% were male, and 29.2% had history of recurrent hernia. The average time since surgery to survey was 60.2 ± 18.8 months. Overall, mean BDRS was 9.9 ± 14.5, and 95.9% agreed that surgery was the right decision, with 85.4% reporting minimal regret and 52.1% reporting no regret. Ventral hernias comprised 47.9% of cases and had the lowest mean regret (3.9 ± 6.6), with no patients scoring > 25. Inguinal (31.3%) and umbilical (8.3%) hernias had higher mean scores (16.7 ± 17.2 and 23.8 ± 18.9, respectively). Among the 7 (14%) patients with scores > 25, all were primary hernias, and most reported postoperative discomfort or minor wound complications. Correlation analyses comparing preoperative survey with postoperative BDRS scores found very early expectation of recovery and graduate-level education were associated with higher regret scores.
conclusionLong-term DR following mesh-based HR is uncommon, with most patients reporting minimal or no regret an average of 5 years postoperatively. Ventral hernia repair had the lowest DR, while inguinal and umbilical repair had higher scores. These findings suggest that mesh-based hernia repair is associated with favorable long-term, patient-reported decision satisfaction.
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