Comparison of medium-weight vs heavy-weight mesh in minimally invasive extraperitoneal ventral hernia repairs.

backgroundMinimally invasive (MIS) extraperitoneal ventral hernia repair (VHR) has become increasingly common, however, limited data exist comparing medium-weight (MW) versus heavyweight (HW) mesh in this setting. We hypothesized that HW mesh in this context would be associated with decreased rates of hernia recurrence at 1 year and beyond compared to MW mesh.

methodsWe conducted a retrospective analysis of prospectively collected data from the Abdominal Core Health Quality Collaborative database, identifying adults who underwent MIS extraperitoneal (preperitoneal and/or retromuscular) VHR with either MW (40-60 g/m

results821 patients were identified. After propensity score matching, 238 patients remained (119 MW, 119 HW). Most baseline covariates were well-matched. Patients with umbilical hernias were more likely to receive MW mesh (80% vs. 65%, p =0.009), while patients receiving HW mesh were more likely to have subxiphoid hernias (5.9% vs 15%, p =0.020). There were no documented SSI at 30 days. The rates of SSO (p =0.696), SSOPI (p =0.498), and 30-day reoperation (p =0.999) were similar between groups. At 1-year, pragmatic recurrence was similar between MW and HW patients (7.6% vs 12.6%, p =0.196).

conclusionsMW and HW mesh demonstrate comparable early and mid-term outcomes following MIS extraperitoneal VHR. Further prospective study and long-term follow-up are necessary as these techniques proliferate.