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Invited Commentary
November 21, 2018

Is Mesh Prophylaxis the Answer to the Prevention of Incisional Hernia?

Author Affiliations
  • 1Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Quebec, Canada
  • 2Department of Surgery, McGill University, Montreal, Quebec, Canada
  • 3Department of Surgery, University of Minnesota, Minneapolis
  • 4Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota
JAMA Surg. Published online November 21, 2018. doi:10.1001/jamasurg.2018.4246

Incisional hernia is a common complication of abdominal surgery that impairs quality of life and body image, can result in incarceration, has a high recurrence rate, and is costly to treat.1 Can this cycle be prevented in the first place? An increasing body of evidence supports the efficacy of prophylactic onlay or retrorectus nonabsorbable synthetic mesh to prevent incisional hernia in high-risk patients.2-4 However, many questions remain, including questions on long-term outcomes, patient selection, mesh type, and mesh position.

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