Mesh in Elective Hernia Repair: 10-Year Experience with over 6,000 Patients.

BACKGROUND The use of mesh in hernia repair has faced intense scrutiny, leading patients to become fearful of its use despite its benefits in reducing hernia recurrence. We report a single institutional experience in performing hernia repair with mesh in terms of hernia-specific outcomes, mesh-related complications and patient-reported quality of life. STUDY DESIGN Patients who underwent abdominal wall hernia repair with mesh at a single institution were identified from a prospectively maintained quality database. Demographic, perioperative and postoperative outcome data were analyzed. Surgical Outcomes Measurements System (SOMS) and Carolinas Comfort Scale (CSS) surveys were administered pre- and postoperatively at 3 weeks, 6 months, 1, 2 and 5 years. RESULTS Between 2010 and 2020, a total of 6,387 patients underwent abdominal hernia repair with mesh. Inguinal hernia repairs made up the majority (65%) of the operations. Rates of mesh infection varied by hernia type, with lower rates after umbilical (0.0%) and inguinal (0.4%) repair and highest after incisional repair (1.3%). Similarly, mesh explantation rates were low after umbilical and inguinal repair (0.0 and 0.4%, respectively) and highest after incisional repair (3.0%). Scores on all SOMS domains were significantly improved from baseline (all p < 0.05). On CCS, 2.9%, 3.3% and 4.4% of patients reported severe or disabling symptoms postoperatively at 1, 2 and 5 years, respectively. CONCLUSION Rates of mesh-related complications vary by hernia type. A majority of patients report excellent long-term quality of life although a relatively large percentage of patients experience severe or disabling symptoms at long-term follow up.