[Mesh shrinkage in hernia surgery: data from a prospective randomized double-blinded clinical study]

Area of Science:

• Surgical innovation
• Biomaterials science
• Abdominal surgery

Background:

• Current hernia repair dogma mandates 5 cm mesh overlap due to presumed significant mesh shrinkage.
• Limited empirical data exists to validate the extent of mesh shrinkage after hernia repair.

Purpose of the Study:

• To investigate mesh shrinkage, recurrence, and complication rates in ventral hernia repair.
• To compare heavyweight and lightweight polypropylene (PP) meshes.
• To evaluate patient quality of life following mesh repair.

Main Methods:

• Prospective randomized double-blinded clinical trial with 50 patients undergoing open sublay ventral hernia repair.
• Comparison of conventional heavyweight (P group, n=27) and lightweight (NK group, n=23) PP meshes.
• Follow-up included X-rays and CT scans over 24 months to assess mesh shrinkage, recurrence, and complications.

Main Results:

• 92% of meshes showed no shrinkage; only 8% exhibited moderate shrinkage, exclusively in the heavyweight group.
• No hernia recurrences were observed.
• Complication rates were low and similar between groups (1 seroma in P, 1 hematoma in NK).
• Quality of life improved over 2 years, with a trend favoring lightweight meshes.

Conclusions:

• Polypropylene meshes generally do not shrink after uncomplicated ventral hernia repair.
• Moderate shrinkage is rare and associated with heavyweight meshes.
• Recurrence and complication rates are comparable between heavyweight and lightweight PP meshes.
• Quality of life improves significantly, with a potential benefit for lightweight meshes.