Ventral Hernia Mesh Linked to Lower Recurrence Rates than Non-Mesh Repair Surgery

Patients who receive a hernia mesh implant are less likely to need additional surgeries than those who undergo hernia repair surgery without a mesh, according to the findings of a new study.

Hernia mesh implants were linked to a 45% chance of needing a follow-up surgery, according to findings published last month in the medical journal JAMA Surgery, which compared to 74% of patients undergoing non-mesh hernia surgery requiring a follow up procedure.

A ventral hernia occurs in the abdominal area, typically devloping at birth or after an incision from another abdominal surgery does not heal properly. This can be addressed either with a hernia repair surgery alone, or through the use of a synthetic or organic mesh patch implanted to treat the condition.

Some patients are better candidates for mesh surgery, while some patients simply don’t want to undergo a hernia mesh repair surgery. Factors for deciding which procedure is better include body weight and distribution, height, medical history, and prior surgeries.

In this study, researchers from the Ohio State University Werner Medical Center examined data on more than 35,000 patients who underwent at least one prior ventral hernia repair, including 30,000 who underwent repair with mesh and 5,600 who underwent hernia repair without mesh.

The study used data from the Abdominal Core Health Quality Collaborative registry to evaluate surgery recurrence rates; the number of patients who needed to have another surgery after undergoing the first, among patients with prior ventral hernia repair between January 2012 and August 2022.

Overall, patients who received a ventral hernia mesh implant faced had a lower chance of needing to have a repeat surgery, compared to patients who did not have a hernia repair surgery using mesh. Recurrent surgery for a ventral hernia can greatly affect patient quality of life and increase the risk of needing follow up surgeries in the future.

The data indicates the risk of needing a repeat surgery was similar for both mesh and non-mesh patients at six months after surgery. But by one year after surgery, the rate of recurrence was significantly different and more patients who had non-mesh surgery (33%) needed repeat surgery compared to those who originally had mesh surgery (8%).

The risk of needing follow-up surgery continued to grow for non-mesh patients, reaching 53% two years after surgery, 62% three years later, and 71% four years later.

Comparatively, for patients implanted with a hernia mesh, their risk remained at 20% at 2 years, 30% by 3 years, and only 39% by the 4-year mark.

Patients with a higher body mass index, taking immunosuppressant drugs, who had larger hernia incisions during prior surgeries, or who suffered infections after hernia surgeries faced a greater risk of needing another surgery later, researchers determined.

It is important to continue to follow up with patients who undergo hernia surgery to help prevent the need for more surgeries in the future, the researchers determined. Patients who haven’t undergone mesh surgery may need to have more frequent follow-ups to prevent a repeat hernia and avoid recurring surgery.

“In this study, the 5-year recurrence rate after ventral hernia repair was greater than 40% and 70% in patients with and without mesh, respectively,” the researchers concluded. “Rates of ventral hernia recurrence increased over time, underscoring the importance of close, long-term follow up in this population.”

Hernia Mesh Lawsuits

The findings come at a time when several major hernia mesh manufacturers, including Covidien and C.R. Bard, face thousands of hernia mesh lawsuits filed by individuals who say they received synthetic mesh devices that were defectively designed, resulting in painful and debilitating injuries.

More than 21,000 product liability lawsuits have been filed against C.R. Bard throughout the federal court system, each involving similar allegations that users suffered painful and debilitating injuries caused by design defects associated with various polypropylene products sold in recent years, including the Bard Ventralight, Bard Ventralex, Bard Perfix Plug, Bard 3DMax, and other similar systems.

In addition, Covidien currently faces nearly 1,100 product liability lawsuits in the federal court system, as well as hundreds of additional claims pending in Massachusetts state court, each raising similar allegations that certain Covidien mesh were also defectively designed,  including Covidien Parietex, Covidien Symbotex and others.