To Örebro University

Introduction: Aim: To compare preperitoneal ventral mesh patch with barbed suture in ventral hernia repair, evaluating recurrence rates and complications, and to assess the safety and efficacy of standardised preperitoneal patch placement.

Methods: In this randomised controlled trial, 205 adult patients undergoing ventral hernia repair were randomised 1:1 to either a ventral mesh patch repair group (n=103) or a 2.0 non-absorbable barbed suture repair group (n=102), blinded to patients and outcome assessors. Primary outcome was recurrence one year after surgery. Pain, nausea, and surgical site events were assessed on four occasions up to one year.

Results: 205 patients were randomised to ventral mesh patch repair (n=103) or barbed suture repair (n=102). Hernia recurrence at one year was lower in the ventral patch group (1.9% vs. 5.9%), though not statistically significant (p=0.14). Surgical site infection rate at one month was significantly less in the ventral patch group (0.9% vs. 6.9%; p=0.02). At one month, the ventral patch group had higher "Pain right now" scores on the VHPQ (p=0.02), this difference had disappeared by one year.

Discussion: Conclusion: Preperitoneal ventral hernia patch repair is a safe and effective technique that results in a lower recurrence rate (though not statistically significant) than barbed suture. While postoperative pain scores at one month were higher in the patch group, this difference had disappeared by one year.