Placing prophylactic synthetic mesh during abdominal closure significantly lowers incisional hernia rates after hepatobiliopancreatic surgery.

• At 12 months, incisional hernia rates were 5.2% in the mesh group vs. 21% in the non-mesh group (p<0.01).
• At 24 months, hernia rates were 8.1% in the mesh group vs. 37.5% in the non-mesh group (p<0.001).

Patients receiving mesh also showed improved functional recovery without increased complications. This data suggests that surgeons may consider prophylactic mesh in high-risk patients undergoing subcostal incisions to mitigate hernia formation.