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May 8, 2026World Journal of Surgery

Association Between Mesh Placement and Recurrence and Chronic Pain After Incisional Hernia Repair: A Systematic Review and Network Meta‐Analysis

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Authors

CWCamilla WitthøftUAUsamah AhmedEGEvy Á Lakjuni Guttesen

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Overview

Systematic review compares recurrence and chronic pain based on mesh placement in incisional hernia repair, suggesting a potential benefit of retromuscular placement.

Key Points

  • The review aimed to evaluate the impact of different mesh placements on recurrence rates and chronic pain following incisional hernia repair.
  • Included studies with adults undergoing elective incisional hernia repair for defects < 10 cm.
  • Conducted meta-analyses and a network meta-analysis to compare recurrence rates based on mesh placements.
  • Utilized Cochrane's Risk of Bias tool for RCTs and an appropriate tool for cohort studies.
  • Crude recurrence rates were highest for preperitoneal (12.8%) and lowest for retromuscular (3.0%) placements.
  • Retromuscular placement was associated with a lower risk of recurrence (RR 0.3, 95% CI 0.1-0.8) compared to onlay.
  • Intraperitoneal placement also showed lower risk of recurrence (RR 0.4, 95% CI 0.2-0.9) than onlay.

Cite This Study

Witthøft et al. (2026) studied this question.

synapsesocial.com/papers/69fd7f4fbfa21ec5bbf07c16https://doi.org/10.1002/wjs.70390
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Mesh Placement and Risk of Recurrence and Bowel Obstruction After Primary Ventral Hernia Repair2026 · 5 citations
  2. 2Mesh placement and patient-reported outcomes in primary ventral hernia repair: a nationwide survey- and register-based study2026
  3. 3HERNIA RECURRENCE AFTER LAPAROSCOPIC MESH REMOVAL FOR CHRONIC POSTOPERATIVE INGUINAL PAIN FOLLOWING PREPERITONEAL REPAIR: LONG-TERM OUTCOMES2024
  4. 4THE IMPORTANCE OF HORIZONTAL MESH OVERLAP IN OPEN RETROMUSCULAR MIDLINE INCISIONAL HERNIA REPAIR: NATIONWIDE ANALYSIS WITH LONG-TERM FOLLOW-UP2024
  5. 5Recurrence and chronic pain comparing mesh versus suture repair for smaller umbilical hernias in adults: the randomised clinical SUMMER trial2025