Hernia Mesh and Hernia Repair: A Review

Abstract

Hernia repair for primary and incisional hernia is the most commonly performed abdominal surgery done with extremely high costs. Treatment for hernia requires surgery to close the defect; however, there are post-operative complications like chronic pain, adhesion, and infection that are common. Hernia repair involves two types of biomaterials: a fixation biomaterial and a mesh biomaterial to close the defect. Synthetic meshes, mostly made from different polymers, provide adequate mechanical support but are associated with postoperative complications like infection. Biological meshes are derived from allografts and xenografts that are prone to less infection; however, their mechanical strength may be too weak depending the characteristics of the hernia defect. Novel meshes being developed try to combat the post-operative complications of current surgical meshes. Composite meshes that have two different surfaces have shown to have less adhesion effects but still produce varying inflammatory responses. Drug-loaded meshes are also a novel mesh that is designed to reduce infection with antibiotics. This review will highlight the different fixation methods as well as the pros and cons of different mesh options. Possible future improvements will be highlighted as well.

Keywords

• Hernia
• hernia repair
• abdominal wall
• hernia mesh
• mesh materials
• biomaterials