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Updated: Jun 27, 2026
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Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
Hernia recurrence after laparotomy: how to close an incised light-weight mesh?
Jörg Höer1, Christian Roesel, Alexander Schachtrupp
1Department of General, Vascular and Visceral Surgery, Marien Hospital Düsseldorf, Rochusstrasse 2, 40479 Düsseldorf, Germany. j.hoeer@marien-hospital.de
Expert Review of Medical Devices
|November 26, 2008
Summary
Mesh repair for incisional hernias can fail, leading to recurrence. This case highlights how mesh material and scar formation impact mechanical stability, suggesting a need for specific repair guidelines.
Area of Science:
- Surgical innovation
- Biomaterials science
- Gastroenterology
Background:
- Incisional hernia (IH) repair frequently involves mesh implantation.
- A growing number of patients require relaparotomy due to mesh complications.
- No standardized recommendations exist for incisional closure in surgical mesh procedures.
Observation:
- A central IH recurrence was observed 16 months post-laparotomy.
- The recurrence occurred through a partially absorbable mesh in the retromuscular plane.
- The initial laparotomy was necessitated by a small bowel ileus.
Findings:
- The recurrence was repaired using a heavy-weight, monofilament polypropylene mesh in the retromuscular position.
- Reducing nonabsorbable material in large-pore hernia meshes can decrease scar plate thickness.
- Overly thinned scar tissue, when cut and resutured, may lack mechanical integrity, leading to 'blow-out' recurrences.
Implications:
- Reinforcement with a nonabsorbable, small-pore polypropylene mesh in the retromuscular space is a viable strategy for IH recurrence.
- This approach facilitates the development of a mechanically stable scar.
- Further research is needed to establish best practices for mesh closure to prevent IH recurrence.
