LAUSR

BACKGROUND The use of mesh in hernia repair has faced intense scrutiny, leading patients to become fearful of its use despite its benefits in reducing hernia recurrence. We report a single institutional experience in performing hernia repair with mesh in terms of hernia-specific outcomes, mesh-related complications and patient-reported quality of life. STUDY DESIGN Patients who underwent abdominal wall hernia repair with mesh at a single institution were identified from a prospectively maintained quality database. Demographic, perioperative and postoperative outcome data were analyzed. Surgical Outcomes Measurements System (SOMS) and Carolinas Comfort Scale (CSS) surveys were administered pre- and postoperatively at 3 weeks, 6 months, 1, 2 and 5 years. RESULTS Between 2010 and 2020, a total of 6,387 patients underwent abdominal hernia repair with mesh. Inguinal hernia repairs made up the majority (65%) of the operations. Rates of mesh infection varied by hernia type, with lower rates after umbilical (0.0%) and inguinal (0.4%) repair and highest after incisional repair (1.3%). Similarly, mesh explantation rates were low after umbilical and inguinal repair (0.0 and 0.4%, respectively) and highest after incisional repair (3.0%). Scores on all SOMS domains were significantly improved from baseline (all p < 0.05). On CCS, 2.9%, 3.3% and 4.4% of patients reported severe or disabling symptoms postoperatively at 1, 2 and 5 years, respectively. CONCLUSION Rates of mesh-related complications vary by hernia type. A majority of patients report excellent long-term quality of life although a relatively large percentage of patients experience severe or disabling symptoms at long-term follow up.