# Prevention of Abdominal Ventral Hernia Using a Poly-4-Hydroxybutyrate Monofilament Mesh in Patients Undergoing Ventriculoperitoneal Shunt Placement for Hydrocephalus

## TL;DR

Using a specific mesh during brain shunt surgery helps prevent hernias and reduces the need for repeat surgeries.

## Contribution

The study introduces the use of P4HB monofilament mesh in VP shunt surgery to prevent hernias and reduce revisions.

## Key findings

- Group B had lower hernia formation and fewer shunt revisions compared to Group A.
- BMI and recurrence interval were key predictors of shunt revision with specific thresholds identified.

## Abstract

Background

The study aimed to evaluate the efficacy of poly-4-hydroxybutyrate (P4HB) monofilament mesh in preventing abdominal ventral hernia and reducing shunt revisions due to catheter migration in patients undergoing ventriculoperitoneal (VP) shunt surgery for hydrocephalus.

Methods

This retrospective, single-center study included patients who underwent VP shunt surgery for hydrocephalus between 2017 and 2022. Patients were divided into two groups: Group A (no mesh placement) and Group B (mesh placement using P4HB monofilament mesh for hernia prevention). Data were collected and analyzed to assess the outcomes of hernia prevention and shunt revision rates in both groups.

Results

Among the 46 patients analyzed, Group B (mesh placement) showed a lower incidence of hernia formation and fewer shunt revisions compared to Group A. BMI and recurrence interval were identified as key predictors of shunt revision, with thresholds of 24.05 kg/m² and 17 months demonstrating high sensitivity and specificity.

Conclusions

The use of P4HB monofilament mesh in VP shunt surgery effectively reduces hernia formation and shunt revisions. Incorporating this mesh into surgical practice may improve outcomes for patients with hydrocephalus.