[Meshes in inguinal hernia repair]

Area of Science:

• Surgical innovation
• Biomaterials science
• Hernia repair techniques

Background:

• Prosthetic mesh implantation is utilized in approximately 50% of groin hernia repairs.
• Despite widespread use, recurrence rates have not significantly decreased with mesh implantation policies.

Purpose of the Study:

• To evaluate the long-term efficacy and complication profile of various prosthetic mesh materials used in inguinal hernia repair.
• To emphasize the importance of individualized risk-benefit analysis before mesh implantation.

Main Methods:

• Review of available literature on prosthetic mesh materials (PTFE, polyester, polypropylene) for hernia repair.
• Analysis of reported complications associated with different mesh types and patient-specific factors.

Main Results:

• PTFE meshes exhibit long-term bioinstability and increased infection rates, rendering them unsuitable for inguinal hernia repair.
• Polyester meshes lack long-term stability and trigger chronic foreign body reactions.
• Polypropylene meshes induce acute inflammation and fibrosis, often linked to mesh weight.
• Common complications include seroma, infection, mesh migration, vas deferens damage, recurrence due to fiber shrinkage, adhesions, and chronic pain.

Conclusions:

• The choice of mesh material significantly impacts outcomes and complication risks in inguinal hernia repair.
• Individual patient assessment, including hernia classification, prior surgeries, and potential collagen metabolism defects, is crucial.
• Prosthetic meshes should be reserved for cases with strong indications, considering unknown long-term patient risks.