Barbed suture versus preperitoneal ventral patch in medium-size ventral hernia repair: randomized clinical trial

Area of Science:

• Surgical Innovation
• Hernia Repair Techniques
• Clinical Trials

Background:

• Ventral hernias are common surgical conditions requiring repair.
• Current repair methods include mesh and suture techniques, each with associated risks and benefits.
• Comparing preperitoneal ventral mesh patch repair with barbed suture repair is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the recurrence rates and complication profiles of preperitoneal ventral mesh patch repair versus barbed suture repair.
• To evaluate the safety and efficacy of preperitoneal mesh patch placement in ventral hernia repair.
• To assess long-term outcomes, including pain and surgical site events.

Main Methods:

• A randomized clinical trial involving 205 adult patients undergoing ventral hernia repair.
• Patients were randomized 1:1 to either ventral mesh patch repair or barbed suture repair, with blinding of patients and outcome assessors.
• Primary outcome was 1-year recurrence; secondary outcomes included pain, nausea, and surgical site events assessed at multiple time points.

Main Results:

• The ventral mesh patch group had a lower recurrence rate (1.9% vs. 5.9%) at 1 year, though not statistically significant (P=0.14).
• Surgical site infection rates at 1 month were significantly lower in the ventral patch group (0.9% vs. 6.9%; P=0.02).
• Postoperative pain scores at 1 month were higher in the ventral patch group (P=0.02) but normalized by 1 year.

Conclusions:

• Preperitoneal ventral hernia patch repair is a safe and effective technique.
• The recurrence rate difference between patch and barbed suture repair was not statistically significant.
• Despite higher initial pain, ventral patch repair demonstrates a favorable safety profile with reduced infection rates.