Incisional Ventral Hernia Repair Trends in the Last Decade: An Achqc Nationwide Database Analysis

Abstract Aim This study evaluates the trends in incisional ventral hernia repair (IVHR) techniques and their outcomes over ten years in the United States. Material and Methods A retrospective review of IVHR from the Abdominal Core Health Quality Collaborative (ACHQC) database (a US Nationwide hernia registry) was conducted from January 2013 to December 2022. Adult patients who underwent incisional ventral hernia repair using different techniques and with 30-day follow-ups were included. Results 22,434 patients were included after applying inclusion and exclusion criteria. The use of the robotic approach increased from 8.0% (2013–2015) to 36.4% (2019–2022), while the open technique decreased from 69.9% to 55.9%. Median Mesh/hernia width increased over time from 2.5 (IQR 1.9–3.4) to 2.7 (IQR 2–3.7) (p 0.001), along with median mesh width from 17 cm (IQR 13–17) to 19 cm (IQR 12-30) (p 0.001). There is a decreasing trend of biologic mesh use from 4.98% to 2.6%. Regarding mesh positioning, retromuscular repair increased from 52.2% to 63.1%, preperitoneal decreased from 12.6% to 11.6% and intraperitoneal decreased from 34.4% to 23.9% (p 0.001). 30-Day readmission, recurrence, SSI (Surgical Site Infection) and reoperation across groups were the same. There was a decrease in SSO (Surgical Site Occurrence) over time from 15% to 10% (p 0.001). Conclusion This study highlights a significant trend toward MIS techniques in IVHR over the last decade. This shift is accompanied by consistently minimal intraoperative complications using bigger meshes in larger defects. There is a decrease in SSO rates and biologic mesh usage.