Laparoskopische Narbenhernien-Reparation – Muss das Netz für die intraperitoneale Onlay-Mesh-Technik besondere Eigenschaften haben?

Abstract

Laparoscopic Incisional Hernia Repair – Is It Necessary that the Mesh Used in Intraperitoneal Onlay Mesh Technique Has Specific Characteristics Different trials showed advantages of laparoscopic incisional hernia repair over open mesh repair in terms of convalescence and low recurrence rates. Due to the direct contact of mesh and intestine, the choice of the appropriate prosthetic material is of great importance in performing the intraperitoneal onlay mesh (IPOM) technique. The ‘ideal’ mesh should lead to scar formation and provide adequate strength to the repair and, at the same time, should avoid formation of visceral adhesion. The basic elements of the available biomaterials are expanded polytetrafluorethylene (ePTFE), polyester, and polypropylene. On the basis of our experience and reports in the literature, the biocompatibility properties and the complications of various meshes are analyzed and discussed. None of these biological materials can be described with the term ‘ideal mesh’. All available prosthetic materials lead to a foreign-body reaction but are associated with an acceptable complication rate. With respect to the short history of laparoscopic hernia repair and the lacking of data, the question which mesh is the better one cannot yet be answered.