Objectives: This study aimed to assess recurrence rates in incisional hernia repairs, comparing open and laparoscopic approaches, and to evaluate whether recurrence differed with or without the use of prosthetic mesh. A secondary objective was to explore the potential benefits of establishing an Incisional Hernia Multidisciplinary Team (MDT) and a dedicated theatre list to improve service delivery and patient outcomes within the Healthboard.

Methods: A retrospective cohort study was conducted across two district general hospitals, including 216 patients who underwent incisional hernia repairs between 4th January 2019 and 28th December 2024. Data on patient demographics, hernia type (primary vs. recurrent), surgical approach (open vs. laparoscopic), and mesh usage were collected and analysed.

Results: Of the 216 patients, 80 were male (37%) and 136 female (63%), with 55 recurrent and 161 primary hernias. Most procedures were open repairs (194; 89.8%), while 19 (8.8%) were laparoscopic. Mesh was used in 147 cases (68%) and omitted in 67 (31%).

The overall recurrence rate was 7.9% (17/216), with mesh repairs showing a recurrence rate of 8.2% (12/147) and non-mesh repairs 7.5% (5/67). Open repairs had a recurrence rate of 7.7% (15/194), compared to 15.8% (3/19) for laparoscopic repairs. Elective repairs had a recurrence rate of 8.5% (14/164) versus 7.7% (4/52) for emergency cases.

Conclusions: This study found low overall recurrence rates (7.9%) for incisional hernia repairs. Mesh use did not significantly reduce recurrence compared to non-mesh repairs (8.2% vs. 7.5%). Laparoscopic repairs had a higher recurrence rate (15.8%) than open repairs (7.7%), though the small laparoscopic sample size limits conclusions. Recurrence rates were similar between elective and emergency cases. These findings suggest that recurrence may be influenced more by patient or hernia factors than surgical approach or mesh use. A structured MDT and dedicated theatre list could support improved patient selection, standardised techniques, and better outcomes. Longer term follow up and a prospective study leg could help to further explore the findings of this study and support the implementation of an MDT approach for the management of incisional hernias.