Can Surgeons Accurately Identify Mesh Type When Interpreting Computed Tomography Scans After Ventral Hernia Repair?

Background Recurrent ventral hernia repair can be a challenging procedure. Given the challenges of acquiring complete and accurate prior operative reports, surgeons often rely on CT scans to obtain information and plan for re-operation. Still, the contribution of CT scans and the ability of surgeons to interpret them is controversial. Here, we assessed the accuracy of expert abdominal wall reconstruction (AWR) surgeons in identifying the type of prior mesh using CT imaging. Methods Twenty-two highly experienced AWR surgeons were asked to evaluate 21 CT scans of patients who had undergone open AWR with bilateral transversus abdominis release utilizing mesh. The surgeons were required to identify the mesh type from a multiple-choice selection. Additionally, negative controls (patients without a history of prior laparotomy) and positive controls (patients with laparotomy but no ventral hernia repair) were incorporated. Results The accuracy rate in correctly identifying mesh type was 46%, with heavy-weight synthetic mesh (HWSM) being identified only 35.4% of the time, Strattice mesh and medium-weight synthetic mesh (MWSM) were identified at 46.3%, and 51.8% respectively. The interrater reliability analysis found a moderate level of agreement 0.428, and the Repeatability measure was poor – 0.053 (95% CI 0–0.119); this indicates that surgeons cannot reliably replicate the identification process. Conclusions Surgeons’ ability to accurately identify the type of previous mesh using CT scans is poor. This study underscores the importance of documenting the type of mesh used in the operative report and the need for standardized operative notes to improve the accuracy and consistency of documentation.