Biologic vs synthetic mesh for single-stage repair of contaminated ventral hernias. A randomized clinical trial.

Aiolfi A, Cavalli M, Ferraro SD, Manfredini L, Bonitta G, Bruni PG et al.
Ann Surg 2021; 274: 954-961.

Some 35 trials covering the three main methods of inguinal hernia were included, with a total of 7777 patients. Hernia recurrence rates were similar across all methods. Pain within 48 hours of surgery, and chronic groin pain were reduced with minimally invasive methods, as were wound complications.

Comment: Minimally invasive hernia repair has short term advantages, but whether the additional costs over open repair are justified remains unknown.

Krpata DM, Petro CC, Prabhu AS. Tastaldi L, Zolin S, Fafaj A et al.
JAMA Surg 2021; 156: 1085-109

This study evaluated two different weights of hernia mesh in 350 procedures. Compared with standard mesh, medium weight polypropylene mesh did not reduce postoperative pain, quality of life or hernia recurrence after one year: 7 versus 8 per cent.

Comment: The weight of mesh seems unimportant.

Fafaj A, Lo Menzo E, Alaedeen D, Petro CC, Rosenblatt S, Szomstein S et al.

JAMA Surg 2022; 157: 667-674.

Routine use of a urinary catheter did not reduce the risk of postoperative retention in this study that included 491 procedures: 9.6 versus 8.5 per cent, P=0.79.

Comment: It’s time to stop using a catheter routinely in those who can void urine spontaneously preoperatively.