30-day outcomes for self-gripping mesh versus non-self-gripping mesh in minimally invasive extraperitoneal ventral hernia repair.

BACKGROUND

Prior work suggests that use of self-gripping mesh (SGM) may be associated with decreased wound complications and pain compared to non-self-gripping mesh (NSGM) after open ventral hernia repair (VHR). Outcomes following minimally invasive (MIS) extraperitoneal VHR are unknown. We hypothesized that use of SGM in MIS extraperitoneal VHR would be associated with decreased wound complications and postoperative pain.

METHODS

A retrospective cohort study using prospective data from the Abdominal Core Health Quality Collaborative was performed. Adults undergoing clean, elective, MIS retromuscular and/or preperitoneal VHR using permanent synthetic SGM or NSGM were included. Cases with a second mesh, barrier-coated mesh, or anatomic inguinal mesh or without a 30-day follow-up were excluded. 1:1 propensity score matching (PSM) was utilized to generate comparable groups. The primary outcome was 30-day surgical site infection (SSI). Secondary outcomes included surgical site occurrences (SSO), SSO/I requiring procedural intervention (SSOPI), operative time, pain and hernia-related quality of life (HerQLes) at 30 d and 1 year, and hernia recurrence at 1-5 years.

RESULTS

After PSM, 1378 patients remained (689 SGM, 689 NSGM). Baseline covariates were well-matched. Operative time was longer for SGM compared to NSGM cases (p = 0.008). Thirty-day SSI, SSO, and SSOPI were rare and comparable between groups. There was no difference in pain or HerQLes scores at 30-day or 1-year follow-up. Hernia recurrence rates were comparable at 1 year; however, SGM had significantly higher rates of hernia recurrence at 2-4 years.

CONCLUSIONS

There were no observed clinical advantages to use of polyester-based SGM in MIS extraperitoneal VHR, with a concerning trend toward increased long-term hernia recurrence. Further prospective evaluation and long-term surveillance are needed to define the role of SGM in MIS extraperitoneal VHR.