Trans facial Suture Fixation not superior option for Retro muscular Ventral Hernia Repair

New research published in JAMA Surgery revealed that abandoning transfascial suture fixation for open retro muscular ventral hernia repair has similar outcomes to using the fixtures. The results of not using the fixture are not inferior to using them. 

Transfascial (TF) mesh fixation is generally done in open retro muscular ventral hernia repair (RVHR) to reduce hernia recurrence. But these TF sutures may themselves aggravate pain. There is not much literature that supports the fixation to date. Hence researchers conducted prospective, registry-based, double-blinded, noninferiority, parallel-group, randomized clinical trials to determine whether abandonment of TF mesh fixation would result in a non-inferior hernia recurrence rate at 1 year compared with TF mesh fixation in open RVHR.  

About 325 patients with a ventral hernia defect width of 20 cm or less with fascial closure were enrolled at a single center from November 29, 2019, to September 24, 2021, and Followed-up till December 18, 2022. Eligible patients were randomized to mesh fixation with percutaneous TF sutures or no mesh fixation with sham incisions. The primary outcome was to determine whether no TF suture fixation was non-inferior to TF suture fixation for open RVHR about recurrence at 1 year. A 10% noninferiority margin was set. Determining postoperative pain and quality of life were the secondary outcomes.