Biosynthetic mesh significantly lowers hernia recurrence rates.

In a study involving 503 patients undergoing robotic hiatal and paraesophageal hernia repair, the use of biosynthetic mesh significantly reduced long-term anatomic hernia recurrence rates from 44.9% to 24.7% compared to suture-only repairs. Symptomatic recurrence also decreased from 42.2% to 17.2%. Despite comparable short-term outcomes, the findings advocate for biosynthetic mesh reinforcement in managing medium and large hernias, while emphasizing the need for further multicenter randomized studies for conclusive evidence.