New developments in hernia repair: a 2013 update

Management of all types of hernias continues to evolve as technology evolves. Prosthetic options continue to play a pivotal role in selection of techniques for hernia repair. There are 3 broad categories of prosthetics including synthetic, biologic, and the new absorbable biosynthetics. Paralleling prosthetic technology is the evolution of fixation for laparoscopic and open hernia techniques. Evaluations of new permanent and absorbable fixation methods are ongoing by multiple companies. There is a great interest in adhesives for mesh fixation as well as self-adhering prosthetics. Studies in fixation revolve around understanding the compromise between fixation strength and pain caused by different fixation methods. Understanding of the biomechanical properties of fixation options coupled with the understanding of the thresholds of force created by the functional abdominal wall are key to optimizing surgical technique. The clinical ramifications of furthering our understanding of all of these technologies will impact perspectives on future technique selection for hernia repair.