Surgical mesh has become an indispensable tool in hernia repair to improve outcomes and reduce costs; however, efforts are constantly being undertaken in mesh development to overcome postoperative complications. Common complications include infection, pain, adhesions, mesh extrusion and hernia recurrence. Reducing the complications of mesh implantation is of utmost importance given that hernias occur in hundreds of thousands of patients per year in the United States. In the present review, the authors present the different types of hernia meshes, discuss the key properties of mesh design, and demonstrate how each design element affects performance and complications. The present article will provide a basis for surgeons to understand which mesh to choose for patient care and why, and will explain the important technological aspects that will continue to evolve over the ensuing years.
Le Huu NhoR., MegeD., OuaissiM., SielezneffI., SastreB.. Incidence and prevention of ventral incisional hernia.J Visc Surg2012; 149: e3–14.
2.
WechterME, PearlmanMD, HartmannKE. Reclosure of the disrupted laparotomy wound: A systematic review.Obstet Gynecol2005; 106: 376–83.
3.
PauliEM, RosenMJ. Open ventral hernia repair with component separation.Surg Clin North Am2013; 93: 1111–33.
4.
BhanguA., NepogodievD., FutabaK.. Systematic review and meta-analysis of the incidence of incisional hernia at the site of stoma closure.World J Surg2012; 36: 973–83.
5.
SandersDL, KingsnorthAN. The modern management of incisional hernias.BMJ2012; 344: e2843.
6.
PouloseBK, SheltonJ., PhillipsS.. Epidemiology and cost of ventral hernia repair: Making the case for hernia research.Hernia2012; 16: 179–83.
7.
BowerC., RothJS. Economics of abdominal wall reconstruction.Surg Clin North Am2013; 93: 1241–53.
8.
RutkowIM. Demographic and socioeconomic aspects of hernia repair in the United States in 2003.Surg Clin North Am2003; 83: 1045–51, v-vi.
PeraltaR., LatifiR.. Long-term outcomes of abdominal wall reconstruction.what are the real numbers? World J Surg2012; 36: 534–8.
11.
El-GazzazG., EremHH, AytacE., SalcedoL., StocchiL., KiranRP. Risk of infection and hernia recurrence for patients undergoing ventral hernia repair with non-absorbable or biological mesh during open bowel procedures.Tech Coloproctol2013; 17: 315–20.
12.
GronnierC., WattierJM, FavreH., PiessenG., MarietteC.. Risk factors for chronic pain after open ventral hernia repair by underlay mesh placement.World J Surg2012; 36: 1548–54.
13.
BensleyRP, SchermerhornML, HurksR.. Risk of late-onset adhesions and incisional hernia repairs after surgery.J Am Coll Surg2013; 216: 1159–67.
14.
XingL., CulbertsonEJ, WenY., FranzMG. Early laparotomy wound failure as the mechanism for incisional hernia formation.J Surg Res2013; 182: e35–42.
15.
LuijendijkRW, HopWC, van den TolMP. A comparison of suture repair with mesh repair for incisional hernia.N Engl J Med2000; 343: 392–8.
16.
NguyenMT, BergerRL, HicksSC. Comparison of outcomes of synthetic mesh vs suture repair of elective primary ventral herniorrhaphy: A systematic review and meta-analysis.JAMA Surg2014; 149: 415–21.
17.
BreuingK., ButlerCE, FerzocoS.. Incisional ventral hernias: Review of the literature and recommendations regarding the grading and technique of repair.Surgery2010; 148: 544–58.
18.
RamirezOM, RuasE., DellonAL. “Components separation” method for closure of abdominal-wall defects: An anatomic and clinical study.Plast Reconstr Surg1990; 86: 519–26.
JinJ., RosenMJ, BlatnikJ.. Use of acellular dermal matrix for complicated ventral hernia repair: Does technique affect outcomes?J Am Coll Surg2007; 205: 654–60.
21.
SandersDL, KingsnorthAN. From ancient to contemporary times: A concise history of incisional hernia repair.Hernia2012; 16: 1–7.
22.
PoussierM., DeneveE., BlancP.. A review of available prosthetic material for abdominal wall repair.J Visc Surg2013; 150: 52–9.
23.
DeekenCR, MatthewsBD. Characterization of the mechanical strength, resorption properties, and histologic characteristics of a fully absorbable material (poly-4-hydroxybutyrate-PHASIX mesh) in a porcine model of hernia repair.ISRN Surg2013; 2013: 238067.
NagyKK, FildesJJ, MahrC.. Experience with three prosthetic materials in temporary abdominal wall closure.Am Surg1996; 62: 331–5.
26.
BuckJR, FathJJ, ChungSK, SorensenVJ, HorstHM, ObeidFN. Use of absorbable mesh as an aid in abdominal wall closure in the emergent setting.Am Surg1995; 61: 655–7.
27.
SriussadapornS., SriussadapornS., Pak-artR., KrittayakiranaK., PrichayuhdS.. Planned ventral hernia with absorbable mesh: A life-saving method in relaparotomy for septic abdomen.J Med Assoc Thai2010; 93: 449–56.
28.
SymeonidisD., EfthimiouM., KoukoulisG., AthanasiouE., MamaloudisI., TzovarasG.. Open inguinal hernia repair with the use of polyglycolic acid/trimethylene carbonate absorbable mesh: A critical update of the long-term results.Hernia2013; 17: 85–7.
29.
SymeonidisD., EfthimiouM., KoukoulisG., MamaloudisI., IoannouM., TzovarasG.. Open inguinal hernia repair with the use of polyglycolic acid/trimethylene carbonate mesh: Gross and pathologic assessment of the inguinal area at reoperation for recurrence.Hernia2013; 17: 791–4.
30.
MartinDP, BadhwarA., ShahDV. Characterization of poly-4-hydroxybutyrate mesh for hernia repair applications.J Surg Res2013; 184: 766–73.
31.
HjortH., MathisenT., AlvesA., ClermontG., BoutrandJP. Three-year results from a preclinical implantation study of a long-term resorbable surgical mesh with time-dependent mechanical characteristics.Hernia2012; 16: 191–7.
32.
PeetersE., van BarneveldKW, SchreinemacherMH. One-year outcome of biological and synthetic bioabsorbable meshes for augmentation of large abdominal wall defects in a rabbit model.J Surg Res2013; 180: 274–83.
33.
Ruiz-JasbonF., NorrbyJ., IvarssonML, BjorckS.. Inguinal hernia repair using a synthetic long-term resorbable mesh: Results from a 3-year prospective safety and performance study.Hernia2014; 18: 723–30.
34.
BellowsCF, AlderA., HeltonWS. Abdominal wall reconstruction using biological tissue grafts: Present status and future opportunities.Expert Rev Med Devices2006; 3: 657–75.
El-HayekKM, ChandB.. Biologic prosthetic materials for hernia repairs.J Long Term Eff Med Implants2010; 20: 159–69.
37.
BealeEW, HoxworthRE, LivingstonEH, TrusslerAP. The role of biologic mesh in abdominal wall reconstruction: A systematic review of the current literature.Am J Surg2012; 204: 510–7.
38.
SlaterNJ, van der KolkM., HendriksT., van GoorH., BleichrodtRP. Biologic grafts for ventral hernia repair: A systematic review.Am J Surg2013; 205: 220–30.
39.
SmartNJ, MarshallM., DanielsIR. Biological meshes: A review of their use in abdominal wall hernia repairs.Surgeon2012; 10: 159–71.
40.
ButlerCE, BurnsNK, CampbellKT, MathurAB, JaffariMV, RiosCN. Comparison of crosslinked and non-crosslinked porcine acellular dermal matrices for ventral hernia repair.J Am Coll Surg2010; 211: 368–76.
41.
NovitskyYW, RosenMJ. The biology of biologics: Basic science and clinical concepts.Plast Reconstr Surg2012; 130: 9S–17S.
42.
ClemensMW, SelberJC, LiuJ.. Bovine versus porcine acellular dermal matrix for complex abdominal wall reconstruction.Plast Reconstr Surg2013; 131: 71–9.
43.
PeppasG., GkegkesID, MakrisMC, FalagasME. Biological mesh in hernia repair, abdominal wall defects, and reconstruction and treatment of pelvic organ prolapse: A review of the clinical evidence.Am Surg2010; 76: 1290–9.
44.
BellowsCF, SmithA., MalsburyJ., HeltonWS. Repair of incisional hernias with biological prosthesis: A systematic review of current evidence.Am J Surg2013; 205: 85–101.
45.
DitzelM., DeerenbergEB, GrotenhuisN.. Biologic meshes are not superior to synthetic meshes in ventral hernia repair: An experimental study with long-term follow-up evaluation.Surg Endosc2013; 27: 3654–62.
46.
HilesM., Record RitchieRD, AltizerAM. Are biologic grafts effective for hernia repair?: A systematic review of the literature.Surg Innov2009; 16: 26–37.
47.
BilselY., AbciI.. The search for ideal hernia repair; mesh materials and types.Int J Surg2012; 10: 317–21.
48.
CevascoM., ItaniKM. Ventral hernia repair with synthetic, composite, and biologic mesh: Characteristics, indications, and infection profile.Surg Infect (Larchmt)2012; 13: 209–15.
49.
ButlerDL, GoldsteinSA, GuilakF.. Functional tissue engineering: The role of biomechanics.J Biomech Eng2000; 122: 570–5.
BrandtCJ, KammerD., FiebelerA., KlingeU.. Beneficial effects of hydrocortisone or spironolactone coating on foreign body response to mesh biomaterial in a mouse model.J Biomed Mater Res A2011; 99: 335–43.
52.
NovitskyYW, OrensteinSB, KreutzerDL. Comparative analysis of histopathologic responses to implanted porcine biologic meshes.Hernia2014; 18: 713–21.
53.
KlosterhalfenB., KlingeU., RoschR., JungeK.. Long-term Inertness of Meshes. In: SchumpelickV., NyhusL., eds. Meshes: Benefits and Risks.Berlin, Heidelberg: Springer, 2004: 170–8.
54.
GraingerDW. All charged up about implanted biomaterials.Nat Biotechnol2013; 31: 507–9.
JungeK., BinneboselM., von TrothaKT. Mesh biocompatibility: Effects of cellular inflammation and tissue remodelling.Langenbecks Arch Surg2012; 397: 255–70.
57.
KrauseHG, GallowaySJ, KhooSK, LourieR., GohJT. Biocompatible properties of surgical mesh using an animal model.Aust N Z J Obstet Gynaecol2006; 46: 42–5.
58.
BrownR.. Handbook of polymer testing: Physical methods.CRC press, 1999.
59.
PottPP, SchwarzML, GundlingR., NowakK., HohenbergerP., RoessnerED. Mechanical properties of mesh materials used for hernia repair and soft tissue augmentation.PLoS One2012; 7: e46978.
60.
LangerC., NeufangT., KleyC., LierschT., BeckerH.. Central mesh recurrence after incisional hernia repair with Marlex – are the meshes strong enough?Hernia2001; 5: 164–7.
61.
LintinLA, KingsnorthAN. Mechanical failure of a lightweight polypropylene mesh.Hernia2014; 18: 131–3.
62.
PetroCC, NahabetEH, CrissCN. Central failures of lightweight monofilament polyester mesh causing hernia recurrence: A cautionary note.Hernia2015; 19: 155–9.
63.
ZuvelaM., GalunD., Djuric-StefanovicA., PalibrkI., PetrovicM., MilicevicM.. Central rupture and bulging of low-weight polypropylene mesh following recurrent incisional sublay hernioplasty.Hernia2014; 18: 135–40.
64.
JungeK., KlingeU., PrescherA., GiboniP., NiewieraM., SchumpelickV.. Elasticity of the anterior abdominal wall and impact for reparation of incisional hernias using mesh implants.Hernia2001; 5: 113–8.
65.
BerrevoetF., MaesL., De BaerdemaekerL., RogiersX., TroisiR., de HemptinneB.. Comparable results with 3-year follow-up for large-pore versus small-pore meshes in open incisional hernia repair.Surgery2010; 148: 969–75.
66.
ConzeJ., RoschR., KlingeU.. Polypropylene in the intra-abdominal position: Influence of pore size and surface area.Hernia2004; 8: 365–72.
67.
LadurnerR., ChiapponiC., LinhuberQ., MussackT.. Long term outcome and quality of life after open incisional hernia repair – light versus heavy weight meshes.BMC Surg2011; 11: 25.
68.
MemonMA, KhanS., OslandE.. Meta-analyses of lightweight versus conventional (heavy weight) mesh in inguinal hernia surgery.Hernia2012; 16: 497–502.
69.
MartakosP., KarwoskiT.. Healing characteristics of hybrid and conventional polytetrafluoroethylene vascular grafts.ASAIO J1995; 41: M735–41.
70.
KlingeU., KlosterhalfenB.. Modified classification of surgical meshes for hernia repair based on the analyses of 1,000 explanted meshes.Hernia2012; 16: 251–8.
71.
CollageRD, RosengartMR. Abdominal wall infections with in situ mesh.Surg Infect (Larchmt)2010; 11: 311–8.
72.
PetersenS., HenkeG., FreitagM., FaulhaberA., LudwigK.. Deep prosthesis infection in incisional hernia repair: Predictive factors and clinical outcome.Eur J Surg2001; 167: 453–7.
73.
SanchezVM, Abi-HaidarYE, ItaniKM. Mesh infection in ventral incisional hernia repair: Incidence, contributing factors, and treatment.Surg Infect (Larchmt)2011; 12: 205–10.
74.
BrownCN, FinchJG. Which mesh for hernia repair?Ann R Coll Surg Engl2010; 92: 272–8.
75.
KlingeU.. Experimental comparison of monofile light and heavy polypropylene meshes: Less weight does not mean less biological response.World J Surg2007; 31: 867–8.
76.
KlosterhalfenB., JungeK., KlingeU.. The lightweight and large porous mesh concept for hernia repair.Expert Rev Med Devices2005; 2: 103–17.
77.
GoldsteinH.. Selecting the right mesh.Hernia1999; 3: 23–6.
78.
OrensteinSB, SaberskiER, KreutzerDL, NovitskyYW. Comparative analysis of histopathologic effects of synthetic meshes based on material, weight, and pore size in mice.J Surg Res2012; 176: 423–9.
79.
ChatzimavroudisG., PapaziogasB., KoutelidakisI., AtmatzidisK.. Experimental comparison of monofile light and heavy polypropylene meshes: Less weight does not mean less biological response.World J Surg2007; 31: 865; author reply 6.
80.
WeyheD., SchmitzI., BelyaevO.. Experimental comparison of monofile light and heavy polypropylene meshes: Less weight does not mean less biological response.World J Surg2006; 30: 1586–91.
81.
CurrieA., AndrewH., TonsiA., HurleyPR, TaribagilS.. Lightweight versus heavyweight mesh in laparoscopic inguinal hernia repair: A meta-analysis.Surg Endosc2012; 26: 2126–33.
82.
PascualG., Hernandez-GasconB., RodriguezM.. The long-term behavior of lightweight and heavyweight meshes used to repair abdominal wall defects is determined by the host tissue repair process provoked by the mesh.Surgery2012; 152: 886–95.
83.
ZogbiL., TrindadeEN, TrindadeMR. Comparative study of shrinkage, inflammatory response and fibroplasia in heavyweight and lightweight meshes.Hernia2013; 17: 765–72.
84.
KlingeU., KlosterhalfenB., BirkenhauerV., JungeK., ConzeJ., SchumpelickV.. Impact of polymer pore size on the interface scar formation in a rat model.J Surg Res2002; 103: 208–14.
85.
BellonJM, RodriguezM., Garcia-HonduvillaN., Gomez-GilV., PascualG., BujanJ.. Comparing the behavior of different polypropylene meshes (heavy and lightweight) in an experimental model of ventral hernia repair.J Biomed Mater Res B Appl Biomater2009; 89: 448–55.
86.
AgarwalBB, AgarwalKA, MahajanKC. Prospective double-blind randomized controlled study comparing heavy- and lightweight polypropylene mesh in totally extraperitoneal repair of inguinal hernia: Early results.Surg Endosc2009; 23: 242–7.
BaumCL, ArpeyCJ. Normal cutaneous wound healing: Clinical correlation with cellular and molecular events.Dermatol Surg2005; 31: 674–86.
89.
NegroP., CampanelliG., IpponiPL. Selective use of bioabsorbable Gore BIO-A plug and patch for groin hernia repair: Comment to: Open inguinal hernia repair with the use of polyglycolic acid/trimethylene carbonate absorbable mesh: A critical update of the long term results. Symeonidis D, Efthimiou M, Koukoulis G, Athanasiou E, Mamaloudis I, Tzovaras G. Hernia 2013, 17:85-87.Hernia2013; 17: 795–6.
90.
SymeonidisD., EfthimouM., KoukoulisG., TzovarasG.. Is it really worth it?: Reply to: Selective use of bioabsorbable Gore BIO-A plug and patch for groin hernia repair. Negro P, Campanelli G, Ipponi PL, Gossetti F, Dassatti MR, Manto O, D'Amore L.Hernia2013; 17: 795–6. Hernia 2014.
91.
HuangK., DingX., LvB.. Reconstruction of large-size abdominal wall defect using biodegradable poly-p-dioxanone mesh: An experimental canine study.World J Surg Oncol2014; 12: 57.
92.
KlosterhalfenB., KlingeU., SchumpelickV., TietzeL.. Polymers in hernia repair – common polyester vs. polypropylene surgical meshes.J Mater Sci2000; 35: 4769–76.
93.
OstergardDR. Degradation, infection and heat effects on polypropylene mesh for pelvic implantation: What was known and when it was known.Int Urogynecol J2011; 22: 771–4.
94.
SternschussG., OstergardDR, PatelH.. Post-implantation alterations of polypropylene in the human.J Urol2012; 188: 27–32.
95.
CavalloJA, GrecoSC, LiuJ., FrisellaMM, DeekenCR, MatthewsBD. Remodeling characteristics and biomechanical properties of a crosslinked versus a non-crosslinked porcine dermis scaffolds in a porcine model of ventral hernia repair.Hernia2015; 19: 207–18.
96.
RobinsonTN, ClarkeJH, SchoenJ., WalshMD. Major mesh-related complications following hernia repair: Events reported to the Food and Drug Administration.Surg Endosc2005; 19: 1556–60.
97.
JezuporsA., MihelsonsM.. The analysis of infection after polypropylene mesh repair of abdominal wall hernia.World J Surg2006; 30: 2270–8.
98.
BeetsGL, GoPM, van MamerenH.. Foreign body reactions to monofilament and braided polypropylene mesh used as preperitoneal implants in pigs.Eur J Surg1996; 162: 823–5.
99.
GoldsteinHS. Selecting the right mesh.Hernia1999; 3: 23–6.
100.
KlingeU., JungeK., SpellerbergB., PirothC., KlosterhalfenB., SchumpelickV.. Do multifilament alloplastic meshes increase the infection rate? Analysis of the polymeric surface, the bacteria adherence, and the in vivo consequences in a rat model.J Biomed Mater Res2002; 63: 765–71.
AnurovMV, TitkovaSM, OettingerAP. Biomechanical compatibility of surgical mesh and fascia being reinforced: Dependence of experimental hernia defect repair results on anisotropic surgical mesh positioning.Hernia2012; 16: 199–210.
103.
Ahonen-SiirtolaM., VironenJ., MakelaJ., PaajanenH.. Surgery-related complications of ventral hernia reported to the Finnish patient insurance centre.Scand J Surg2015; 104: 66–71.
104.
DietzUA, WinklerMS, HartelRW. Importance of recurrence rating, morphology, hernial gap size, and risk factors in ventral and incisional hernia classification.Hernia2014; 18: 19–30.
105.
HelgstrandF., RosenbergJ., KehletH., JorgensenLN, BisgaardT.. Nationwide prospective study of outcomes after elective incisional hernia repair.J Am Coll Surg2013; 216: 217–28.
106.
LowhamAS, FilipiCJ, FitzgibbonsRJJr. Mechanisms of hernia recurrence after preperitoneal mesh repair. Traditional and laparoscopic.Ann Surg1997; 225: 422.
107.
BarzanaD., JohnsonK., ClancyTV, HopeWW. Hernia recurrence through a composite mesh secondary to transfascial suture holes.Hernia2012; 16: 219–21.
108.
GuerinG., TurquierF.. Impact of the defect size, the mesh overlap and the fixation depth on ventral hernia repairs: A combined experimental and numerical approach.Hernia2013; 17: 647–55.
109.
MuysomsF., Vander MijnsbruggeG., PletinckxP.. Randomized clinical trial of mesh fixation with “double crown” versus “sutures and tackers” in laparoscopic ventral hernia repair.Hernia2013; 17: 603–12.
110.
ReynvoetE., DeschepperE., RogiersX., TroisiR., BerrevoetF.. Laparoscopic ventral hernia repair: Is there an optimal mesh fixation technique? A systematic review.Langenbecks Arch Surg2014; 399: 55–63.
111.
SajidMS, ParampalliU., McFallMR. A meta-analysis comparing tacker mesh fixation with suture mesh fixation in laparoscopic incisional and ventral hernia repair.Hernia2013; 17: 159–66.
112.
BrahmbhattR., MartindaleR., LiangMK. Jumping the gun? Evaluating the evidence for synthetic mesh in contaminated hernia repairs.J Am Coll Surg2014; 218: 498–9.
113.
CrossW., KumarA., Chandru KowdleyG.. Biological mesh in contaminated fields–overuse without data: A systematic review of their use in abdominal wall reconstruction.Am Surg2014; 80: 3–8.
114.
MarietteC., BriezN., DeniesF.. Use of biological mesh versus standard wound care in infected incisional ventral hernias, the SIMBIOSE study: A study protocol for a randomized multicenter controlled trial.Trials2013; 14: 131.
115.
CarbonellAM, CobbWS. Safety of prosthetic mesh hernia repair in contaminated fields.Surg Clin North Am2013; 93: 1227–39.
116.
CarbonellAM, CrissCN, CobbWS, NovitskyYW, RosenMJ. Outcomes of synthetic mesh in contaminated ventral hernia repairs.J Am Coll Surg2013; 217: 991–8.
117.
DeerenbergEB, MulderIM, GrotenhuisN., DitzelM., JeekelJ., LangeJF. Experimental study on synthetic and biological mesh implantation in a contaminated environment.Br J Surg2012; 99: 1734–41.
118.
SuttonPA, EvansJP, UzairS., VargheseJV. The use of Gore Bio-A in the management of the open abdomen.BMJ Case Rep2013; 2013.
119.
GuillaumeO., LavigneJP, LefrancO., NotteletB., CoudaneJ., GarricX.. New antibiotic-eluting mesh used for soft tissue reinforcement.Acta Biomater2011; 7: 3390–7.
120.
ElsnerJJ, ZilbermanM.. Antibiotic-eluting bioresorbable composite fibers for wound healing applications: Microstructure, drug delivery and mechanical properties.Acta Biomater2009; 5: 2872–83.
121.
ElsnerJJ, ZilbermanM.. Novel antibiotic-eluting wound dressings: An in vitro study and engineering aspects in the dressing's design.J Tissue Viability2010; 19: 54–66.
122.
GollwitzerH., IbrahimK., MeyerH., MittelmeierW., BuschR., StembergerA.. Antibacterial poly(D,L-lactic acid) coating of medical implants using a biodegradable drug delivery technology.J Antimicrob Chemother2003; 51: 585–91.
CampocciaD., MontanaroL., SpezialeP., ArciolaCR. Antibiotic-loaded biomaterials and the risks for the spread of antibiotic resistance following their prophylactic and therapeutic clinical use.Biomaterials2010; 31: 6363–77.
125.
WuP., GraingerDW. Drug/device combinations for local drug therapies and infection prophylaxis.Biomaterials2006; 27: 2450–67.
126.
AubeC., PessauxP., TuechJJ. Detection of peritoneal adhesions using ultrasound examination for the evaluation of an innovative intraperitoneal mesh.Surg Endosc2004; 18: 131–5.
127.
SchreinemacherMH, van BarneveldKW, DikmansRE, GijbelsMJ, GreveJW, BouvyND. Coated meshes for hernia repair provide comparable intraperitoneal adhesion prevention.Surg Endosc2013; 27: 4202–9.
128.
BringmanS., ConzeJ., CuccurulloD.. Hernia repair: The search for ideal meshes.Hernia2010; 14: 81–7.
129.
EmansPJ, SchreinemacherMH, GijbelsMJ. Polypropylene meshes to prevent abdominal herniation.Can stable coatings prevent adhesions in the long term? Ann Biomed Eng2009; 37: 410–8.
130.
KoehlerRH, BegosD., BergerD.. Minimal adhesions to ePTFE mesh after laparoscopic ventral incisional hernia repair: Reoperative findings in 65 cases.JSLS2003; 7: 335–40.
131.
Schug-PassC., SommererF., TannapfelA., LippertH., KockerlingF.. Does the additional application of a polylactide film (SurgiWrap) to a lightweight mesh (TiMesh) reduce adhesions after laparoscopic intraperitoneal implantation procedures? Experimental results obtained with the laparoscopic porcine model.Surg Endosc2008; 22: 2433–9.
132.
BergerD.. [Diagnostics and therapy of chronic pain following hernia operation].Chirurg2014; 85: 117–20.
133.
SajidMS, KalraL., ParampalliU., SainsPS, BaigMK. A systematic review and meta-analysis evaluating the effectiveness of lightweight mesh against heavyweight mesh in influencing the incidence of chronic groin pain following laparoscopic inguinal hernia repair.Am J Surg2013; 205: 726–36.
134.
ForstemannT., TrzewikJ., HolsteJ.. Forces and deformations of the abdominal wall – a mechanical and geometrical approach to the linea alba.J Biomech2011; 44: 600–6.
135.
FranzMG, SmithPD, WachtelTL. Fascial incisions heal faster than skin: A new model of abdominal wall repair.Surgery2001; 129: 203–8.
