Hernia Recurrence Risk Matters More Than Mesh Type to Patients Undergoing Ventral Hernia Repair

Area of Science:

• Surgical Innovation
• Patient-Reported Outcomes
• Biomaterials in Medicine

Background:

• Patient understanding of synthetic mesh risks for ventral hernia repair (VHR) may be limited.
• Investigating patient risk tolerance is crucial for informed VHR decision-making.

Purpose of the Study:

• To assess patient thresholds for accepting hernia recurrence risk to avoid synthetic mesh in VHR.
• To understand patient preferences between synthetic and biologic mesh based on risk tolerance.

Main Methods:

• A probability trade-off technique (PTO) was used with 100 VHR patients viewing a decision aid.
• Patients indicated their mesh preference by varying recurrence rates for biologic versus synthetic mesh.
• Linear regression identified factors influencing risk aversion to synthetic mesh.

Main Results:

• A majority of patients (57%) consistently preferred synthetic mesh.
• 3% accepted higher recurrence risk for synthetic mesh; 24% preferred biologic mesh only if recurrence was lower.
• Wound complication information had minimal effect on mesh choice; higher education correlated with higher risk aversion.

Conclusions:

• Most patients prioritize reducing VHR recurrence over mesh type, challenging the assumption of widespread synthetic mesh avoidance.
• Patient goals and priorities for VHR outcomes require further investigation to guide clinical practice.