Hernia repair techniques: a comparative analysis of mesh types

Abstract

A hernia is a condition characterized by the protrusion of an internal organ, often part of the intestine, through a weakened area in the surrounding muscle and tissue. Surgical intervention is the primary treatment option for most hernias, with procedures known as herniorrhaphy or hernioplasty. Traditional open surgery involves a sizable abdominal incision, granting direct access to the herniated tissue. Alternatively, minimally invasive laparoscopic surgery utilizes small incisions and specialized instruments, including a camera, for repair. Synthetic or biological mesh is frequently employed to reinforce weakened muscle or tissue, reducing hernia recurrence risk. Mesh is integral to hernia treatment, providing critical reinforcement and enabling tension-free closure. This article's rationale lies in the necessity for a comprehensive comparative analysis of hernia repair techniques, with a particular focus on the influence of different mesh types in abdominal hernia surgery. This research, initiated on 17 October 2023, involved an exhaustive review of existing literature via databases like PubMed, Web of Science, and Cochrane, employing a broad range of medical terminology combinations. The management of hernias has evolved significantly, and open hernia repair, especially using the Shouldice technique, remains valuable when the mesh is unavailable or undesired. Modern tension-free repair techniques, such as Lichtenstein and plug and patch, provide similar outcomes. Laparoscopic hernia repair, despite the longer surgery duration, offers advantages in terms of recurrence, recovery, and postoperative discomfort. Mesh selection is vital, with options like polypropylene, polyester, composite, biological, and 3D offering tailored attributes. The choice should consider patient history, hernia type, and surgeon expertise, necessitating awareness of evolving techniques and materials for optimal outcomes in hernia repair.