• Ryan Howard, Jyothi Thumma, Anne Ehlers, Michael Englesbe, Justin Dimick, and Dana Telem.
• Department of Surgery, University of Michigan, Ann Arbor, MI.
• Ann. Surg. 2023 Aug 1; 278 (2): 274279274-279.

ObjectiveTo describe national trends in surgical technique and rates of reoperation for recurrence for patients undergoing ventral hernia repair (VHR) in the United States.BackgroundSurgical options for VHR, including minimally invasive approaches, mesh implantation, and myofascial release, have expanded considerably over the past 2 decades. Their dissemination and impact on population-level outcomes is not well characterized.MethodsWe conducted a retrospective cohort study of Medicare beneficiaries undergoing elective, inpatient umbilical, ventral, or incisional hernia repair between 2007 and 2015. Cox proportional hazards models were used to estimate the adjusted proportion of patients who remained free from reoperation for hernia recurrence up to 5 years after surgery.ResultsOne hundred fort-one thousand two hundred sixty-one patients underwent VHR during the study period. Between 2007 and 2018, the use of minimally invasive surgery increased from 2.1% to 22.2%, mesh use increased from 63.2% to 72.5%, and myofascial release increased from 1.8% to 16.3%. Overall, the 5-year incidence of reoperation for recurrence was 14.1% [95% confidence interval (CI) 14.0%-14.1%]. Over time, patients were more likely to remain free from reoperation for hernia recurrence 5 years after surgery [2007-2009 reoperation-free survival: 84.9% (95% CI 84.8%-84.9%); 2010-2012 reoperation-free survival: 85.7% (95% CI 85.6%-85.7%); 2013-2015 reoperation-free survival: 87.8% (95% CI 87.7%-87.9%)].ConclusionsThe surgical treatment of ventral and incisional hernias has evolved in recent decades, with more patients undergoing minimally invasive repair, receiving mesh, and undergoing myofascial release. Although our analysis does not address causality, rates of reoperation for hernia recurrence improved slightly contemporaneous with changes in surgical technique.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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