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Reoperation Versus Self-Reported Recurrence After Ventral Hernia Repair: A Nationwide Survey- and Register-Based
Evy Á Lakjuni Guttesen1, Hugin Reistrup1, Anders Gram-Hanssen1
1Department of Surgery, Center for Perioperative Optimization, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark.
World Journal of Surgery
|July 28, 2026
Summary
Reoperation rates significantly underestimate ventral hernia recurrence, with self-reported recurrences being much higher. This highlights the need for comprehensive assessment beyond surgical reintervention in hernia repair studies.
Area of Science:
- Abdominal Surgery
- Hernia Repair
- Public Health Research
Background:
- Reoperation is a common outcome measure for ventral hernia repair.
- However, reoperation may underestimate true recurrence rates, potentially biasing study interpretations.
- This study investigated the proportion of patients with ventral hernia recurrence who undergo reoperation.
Purpose of the Study:
- To determine the proportion of patients experiencing recurrence after ventral hernia repair who undergo reoperation.
- To compare reoperation rates with overall recurrence rates, including self-reported recurrences.
- To assess the impact of using reoperation as the sole outcome measure in hernia repair research.
Main Methods:
- A nationwide, register-based study (AFTERHERNIA Project) included patients aged ≥18 years undergoing primary ventral or incisional hernia repair (Jan 2014-Mar 2024).
- Patients were identified via the Danish National Patient Register and invited to an electronic survey.
- Recurrence was defined as reoperation for recurrence or self-reported recurrence; prevalences were estimated using regression analyses with marginal standardization.
Main Results:
- The study included 20,703 patients with a median follow-up of 5.5 years.
- For primary ventral hernias, overall recurrence was 15.5% (3.3% reoperation, 12.2% self-reported).
- For incisional hernias, overall recurrence was 27.2% (7.0% reoperation, 20.2% self-reported).
Conclusions:
- Reoperation for recurrence underestimated overall recurrence by approximately fivefold after primary ventral hernia repair.
- Reoperation underestimated overall recurrence by approximately fourfold after incisional hernia repair.
- These findings underscore the importance of including self-reported data to accurately capture hernia recurrence rates.
