Efficacy and Safety of OviTex® Reinforced Tissue Matrix for Ventral Hernia Repair: A Systematic Review and Meta-Analysis

 

Authors:

Maria Clara Morais¹

Mariana de Macedo Torves²

Augusto Graziani e Sousa³

Lorraine Michelle da Silva de Almeida⁴

Leticia Hanna Moura da Silva Gattas Graciolli⁵

Raquel Nogueira⁶

Diego L Lima⁶

 

Affiliations:

¹Department of Surgery, Lenox Hill Hospital, New York, NY, USA.

²Vale do Rio dos Sinos University, São Leopoldo, Brazil.

³Centro Universitário de Anápolis, Anápolis, Brazil.

⁴Federal University of São Paulo, São Paulo, Brazil.

⁵Faculty of Medicine of Jundiaí, Jundiaí, Brazil.

⁶Department of Surgery, Montefiore Medical Center, Bronx, NY, USA.

ABSTRACT

Introduction: OviTex (OviTex®, TELA Bio) mesh is a reinforced tissue matrix that combines biologic and synthetic components, aiming to reduce inflammatory response while providing durable abdominal wall support. Comparative analyses indicate that biosynthetic meshes like OviTex perform similarly to synthetic mesh regarding hernia recurrence and surgical site infection rates, and may be preferable in patients with increased risk factors or prior mesh infection. This systematic review and meta-analysis evaluated the efficacy and safety profile of OviTex, particularly in patients undergoing ventral wall hernia repair (VHR).

Methods: Following PRISMA guidelines, we searched PubMed, Embase, Scopus, and ClinicalTrials.gov from inception to September 2025. Studies comparing the use of Ovitex mesh following VHR were included. The primary endpoint was recurrence rates. Secondary outcomes were surgical site occurrences (SSO) and hospital length of stay (LOS). Statistical analysis was performed with Review Manager 5.4 using a random-effects model.

Results: From 202 records, 9 met our inclusion criteria, to which 4 were included in our final pooled analysis. These studies encompassed 534 patients (Ovitex n = 194 [36.3%]), with a mean follow-up time of 19.3 months, and a mean hernia defect size of 130.3 cm². An open approach was specified in 171 (32%) cases. The overall primary fascial closure rate was 88%, with mesh most frequently placed in the retrorectus (39%) or intraperitoneal (35%) planes. Overall analysis showed significantly reduced recurrence rates (RR 0.45; 95% CI 0.22 to 0.94; p = 0.03) for patients using Ovitex mesh (Figure 1A). There were no significant differences regarding SSO rates (RR 1.27; 95% CI 0.79 to 2.05; p = 0.32) (Figure 1B) and LOS (MD 3.18 days; 95% CI -6.38 to 12.74 days; p = 0.51) (Figure 1C) between groups.

Conclusion: This systematic review and meta-analysis indicate that OviTex® mesh is a safe and effective option for ventral hernia repair, with significantly lower recurrence rates and comparable outcomes in terms of surgical site occurrences and length of stay. These findings support reinforced biologic mesh as a reliable alternative in patients at higher risk.