Our Summary

This study looked at the outcomes of emergency and urgent ventral hernia repairs (VHRs), focusing on whether or not a mesh was used in the repair. They looked at data from surgeries performed between 2013 and 2017 at one academic institution.

Of the 94 patients they studied, 41 had a mesh used in their repair, while 53 did not. They found that the group that did not receive a mesh had a higher rate of hernia recurrence (24.5% vs. 7.3%). There was no significant difference in wound complications between the two groups.

However, they did note that emergency department visits and post-surgery clinic visits were more common among the group that received a mesh.

The study concluded that repairs without a mesh were associated with over three times the risk of hernia recurrence, without any increase in the risk of infection. They suggest further research is needed to understand why some repairs are done without mesh, in order to reduce the rate of hernia recurrence in emergency situations.

FAQs

  1. What was the main focus of the study on emergency and urgent ventral hernia repairs?
  2. Did the study find any difference in hernia recurrence rates between patients who received a mesh and those who did not?
  3. What recommendations have been made based on the study’s findings about hernia repairs with and without a mesh?

Doctor’s Tip

In light of this study, a doctor might advise a patient undergoing hernia repair to consider using a mesh in their procedure. Mesh repairs have been shown to have a lower risk of hernia recurrence compared to repairs without mesh. However, it is important to discuss with your healthcare provider the potential risks and benefits of using a mesh in your specific situation. Additionally, make sure to follow your doctor’s post-operative instructions and attend all scheduled follow-up appointments to monitor your recovery and prevent complications.

Suitable For

Patients who are typically recommended hernia repair are those with symptomatic hernias, such as pain, discomfort, or bulging in the affected area. Patients with larger hernias or hernias that are at risk of complications, such as strangulation or obstruction, may also be recommended for hernia repair. Additionally, patients with recurrent hernias or hernias that have previously been repaired but have failed may also be candidates for hernia repair.

Timeline

Before hernia repair:

  1. Patient experiences symptoms of a hernia, such as a bulge in the abdomen or groin, pain or discomfort, and possible nausea or vomiting.
  2. Patient sees a doctor for evaluation and diagnosis of the hernia.
  3. Doctor determines that hernia repair is necessary and schedules the surgery.
  4. Patient undergoes pre-operative evaluations and tests to ensure they are healthy enough for surgery.

After hernia repair:

  1. Patient undergoes hernia repair surgery, which may involve the use of a mesh to reinforce the weakened area.
  2. Patient stays in the hospital for a short period of time for observation and recovery.
  3. Patient is discharged from the hospital and given instructions for at-home care, including pain management and wound care.
  4. Patient attends follow-up appointments with their surgeon to monitor their recovery and ensure the hernia repair was successful.
  5. Patient gradually resumes normal activities and may experience a decrease in symptoms and improved quality of life.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with hernia repair surgery, both with and without the use of mesh?
  2. What is the success rate of hernia repair surgery with and without mesh, and how does this differ in emergency versus elective situations?
  3. What is the recovery process like after hernia repair surgery, and how long can I expect to be out of work or limited in my activities?
  4. Are there any specific lifestyle changes or precautions I should take after hernia repair surgery to reduce the risk of recurrence?
  5. How often will I need to follow up with you after the surgery, and what signs or symptoms should I watch for that may indicate a complication or recurrence?
  6. What factors do you consider when deciding whether to use mesh in hernia repair surgery, and why might some repairs be done without it?
  7. Are there any alternative treatment options for hernia repair that I should consider or be aware of?
  8. How experienced are you in performing hernia repair surgeries, particularly in emergency situations, and what is your success rate with these procedures?
  9. Can you explain the findings of this study to me in more detail and how they may impact my individual treatment plan?
  10. Are there any additional tests or evaluations that you recommend before proceeding with hernia repair surgery?

Reference

Authors: Whittaker R, Lewis Z, Plymale MA, Nisiewicz M, Ebunoluwa A, Davenport DL, Reynolds JK, Roth JS. Journal: Surg Endosc. 2022 Oct;36(10):7731-7737. doi: 10.1007/s00464-022-09101-4. Epub 2022 Mar 1. PMID: 35233657