Skip to main content

Advertisement

Log in

Mesh repair of common abdominal hernias: a review on experimental and clinical studies

  • Review
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Results on hernia surgery from numerous centers confirm that tensionless repair with various meshes reduces the complication rates and the frequency of recurrences. Some evidence on incisional hernias suggests, however, that the use of mesh seems to transfer the onset of recurrences by several years. Persistent pain and other discomfort is also an unpleasant complication of otherwise successful surgery in a number of patients. Thus, improved, slowly degrading, mesh materials, with strong connective tissue-inducing action, might be more optimal for hernia surgery. Accumulating evidence also suggests that recurrent hernias appear in patients having inherited weakness of connective tissues. Numerous tissue specific collagens, in addition to the classical fibrillar I–III collagens and numerous substrate specific matrix proteinases, have recently been described in biochemical literature, and their roles as possible causes of tissue weakness are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Butters M, Redecke J, Köninger J (2007) Long-term results of a randomized clinical trial of Shouldice, Lichtenstein and transabdominal preperitoneal hernia repair. Br J Surg 94:562–565

    Article  PubMed  CAS  Google Scholar 

  2. Klinge U, Si ZY, Zheng H, Schumpelick V, Bhardwaj RS, Klosterhalfen B (2001) Collagen I/III and matrix metalloproteinases (MMP) 1 and 13 in the fascia of patients with incisional hernias. J Invest Surg 14:47–54

    Article  PubMed  CAS  Google Scholar 

  3. Si Z, Rhanjit B, Rosch R, Mertens PR, Klosterhalfen B, Klinge U (2002) Impaired balance of type I and type III procollagen mRNA in cultured fibroblasts of patients with incisional hernia. Surgery 131:324–331

    Article  PubMed  Google Scholar 

  4. Franz MG (2006) The biology of hernias and the abdominal wall. Hernia 10:462–471

    Article  PubMed  Google Scholar 

  5. Klinge U, Binnebösel M, Mertens PR (2006) Are collagens the culprits in the development of incisional and inguinal hernia disease? Hernia 10:472–477

    Article  PubMed  CAS  Google Scholar 

  6. Lynen Jansen P, Klinge U, Mertens PR (2006) Hernia disease and collagen gene regulation: are there clues for intervention? Hernia 10:486–491

    Article  PubMed  Google Scholar 

  7. Koch M, Schulze J, Hansen U, Ashwodt T, Keene DR, Brunken WJ, Burgeson RE, Bruckner P, Bruckner-Tuderman L (2004) A novel marker of tissue junctions, collagen XXII. J Biol Chem 279:22514–22521

    Article  PubMed  CAS  Google Scholar 

  8. Donahue TR, Hiatt JR, Busuttil RW (2006) Collagenase and surgical disease. Hernia 10:478–485

    Article  PubMed  Google Scholar 

  9. Rahkonen O, Su M, Hakovirta H, Koskivirta I, Hormuzdi SG, Vuorio E, Bornstein P, Penttinen R (2004) Mice with a deletion in the first intron of the Col1a1 gene develop age-dependent aortic dissection and rupture. Circ Res 94:83–90

    Article  PubMed  CAS  Google Scholar 

  10. Mäki JM, Räsänen J, Tikkanen H, Sormunen R, Mäkikallio K, Kivirikko KI, Soininen R (2002) Inactivation of the lysyl oxidase gene, Lox, leads to aortic aneurysms, cardiovascular dysfunction, and perinatal death in mice. Circulation 106:2503–2509

    Article  PubMed  Google Scholar 

  11. Daugherty A, Cassis LA (2004) Mouse models of abdominal aortic aneurysms. Arterioscler Thromb Vasc Biol 24:429–434

    Article  PubMed  CAS  Google Scholar 

  12. Daugherty A, Rateri DL, Cassis LA (2006) Role of the renin-angiotensin system in the development of abdominal aortic aneurysms in animals and humans. Ann N Y Acad Sci 1085:82–91

    Article  PubMed  CAS  Google Scholar 

  13. Rosch R, Lynen-Jansen P, Junge K, Knops M, Klosterhalfen B, Klinge U, Mertens PR, Schumpelick V (2006) Biomaterial-dependent MMP-2 expression in fibroblasts from patients with recurrent incisional hernias. Hernia 10:125–130

    Article  PubMed  CAS  Google Scholar 

  14. http://www.stakes.fi/fi/tilastot (statistics) (in Finnish) (2003)

  15. Kingsnorth A (2004) Treating inguinal hernias. BMJ 328:59–60

    Article  PubMed  Google Scholar 

  16. Douek M, Smith G, Oshowo A, Stoker DL, Wellwood JM (2005) Prospective randomised controlled trial of laparoscopic versus open inguinal hernia mesh repair: five year follow up. BMJ 326:1012–1013

    Article  Google Scholar 

  17. Bringman S, Wollert S, Österberg J, Smedberg S, Granlund H, Fellander G, Heikkinen T (2005) One year results of a randomized controlled multi-centre study comparing Prolene and Vypro II-mesh in Lichtenstein hernioplasty. Hernia 9:223–227

    Article  PubMed  CAS  Google Scholar 

  18. Disa JJ, Klein MH, Goldberg NH (1996) Advantages of autologous fascia versus synthetic patch abdominal reconstruction in experimental animal defects. Plast Reconstr Surg 97:801–806

    Article  PubMed  CAS  Google Scholar 

  19. Ma SZ, Li XH, Hu J (2006) Acellular extracellular matrix for inguinal hernia repair. Hernia 10:229–231

    Article  PubMed  CAS  Google Scholar 

  20. Gilbert AI, Graham MF, Voigt WJ (1999) A bilayer patch device for inguinal hernia repair. Hernia 3:161–166

    Article  Google Scholar 

  21. Canonico S, Santoriello A, Campitiello F, Fattopace A, Corte AD, Sordelli I, Benevento R (2005) Mesh fixation with human fibrin glue (Tissucol) in open tension-free inguinal hernia repair: a preliminary report. Hernia 9:330–333

    Article  PubMed  CAS  Google Scholar 

  22. Campanelli G, Pettinari D, Nicolosi FM, Cavalli M, Avesani EC (2006) Inguinal hernia recurrence: classification and approach. Hernia 10:159–161

    Article  PubMed  CAS  Google Scholar 

  23. Haapaniemi S, Nordin P (2006) Present state of failure rates (clinical studies and epidemiological database, short- and long-term) In: Schumpelick V, Fitzgibbons RJ (eds) Recurrent hernia. prevention and treatment. Springer, Berlin Heidelberg, pp 3–25

    Google Scholar 

  24. Campanelli G, Champault G, Hidalgo Pascual M, Hoeferlin A, Kingsnorth A, Rosenberg J, Miserez M (2007) Randomized, controlled blinded trial of Tissucol/Tisseel for mesh fixation in patients undergoing Lichtenstein technique for primary inguinal hernia repair: rationale and study design of the TIMELI trial. Hernia. doi:10.1007/s10029-007-0315-3

  25. Burger JW, Luijdendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–585

    PubMed  Google Scholar 

  26. Lee YK, Iqbal A, Vitamvas M, McBride C, Thopson J, Oleynikov D (2007) Is it safe to perform laparoscopic ventral hernia repair with mesh in elderly patients? Hernia. doi:10.1007/s10029-007-0312-6

  27. Gonzalez R, Rehnke RD, Ramaswamy A, Smith CD, Clarke JM, Ramshaw BJ (2005) Components separation technique and laparoscopic approach: a review of two evolving strategies for ventral hernia repair. Am Surg 71:598–605

    PubMed  Google Scholar 

  28. Rudmik LR, Schieman C, Dixon E, Debru E (2006) Laparoscopic incisional hernia repair: a review of the literature. Hernia 10:110–119

    Article  PubMed  CAS  Google Scholar 

  29. Moreno Egea DA, Torralba Martinez JA, Morales Cuenca G, De Miquel J, Martın Lorenzo JG, Aguayo Albasini JL, Canteras Jordana M (2004) Mortality following laparoscopic ventral hernia repair: lessons from 90 consecutive cases and bibliographical analysis. Hernia 8:208–212

    Article  Google Scholar 

  30. Tanaka K, Mutter D, Inoue H, Lindner V, Bouras G, Forgione A, Leroy G, Aprahamian M, Marescaux J (2007) In vivo evaluation of a new composite mesh (10% polypropylene/90% poly-L-lactic acid) for hernia repair. J Mater Sci Mater Med 18:991–999

    Article  PubMed  CAS  Google Scholar 

  31. Flum DR, Horvath K, Koepsell T (2003) Have outcomes of incisional hernia repair improved with time? A population based analysis. Ann Surg 237:129–135

    Article  PubMed  Google Scholar 

  32. Brockman JB, Patterson NW, Richardson WS (2004) Burst strength of laparoscopic and open hernia repair. Surg Endosc 18:536–539

    Article  PubMed  CAS  Google Scholar 

  33. Duffy AJ, Hogle NJ, LaPerle KM, Fowler DL (2004) Comparison of the two composite meshes using two fixation devices in a porcine laparoscopic ventral hernia repair model. Hernia 8:358–364

    Article  PubMed  CAS  Google Scholar 

  34. Gonzalez R, Fugate K, McClusky D 3rd, Ritter EM, Lederman A, Dillehay D, Smith CD, Ramshaw BJ (2005) Relationship between tissue ingrowth and mesh contraction. World J Surg 29:1038–1043

    Article  PubMed  Google Scholar 

  35. Uen YH (2004) Comparative laparoscopic evaluation of the PROLENE Polypropylene Hernia System vs. the PerFix Plug repair in a porcine groin hernia repair model. J Laparoendosc Adv Surg Tech A 14:368–373

    PubMed  Google Scholar 

  36. Silverman RP, Li EN, Holton LH 3rd, Sawan KT, Goldberg NH (2004) Ventral hernia repair using allogenic acellular dermal matrix in a swine model. Hernia 8:336–342

    Article  PubMed  CAS  Google Scholar 

  37. Winslow ER, Diaz S, Desai K, Meininger T, Soper NJ, Klingensmith ME (2004) Laparoscopic incisional hernia repair in a porcine model: what do transfixion sutures add? Surg Endosc 8:529–535

    Article  Google Scholar 

  38. Greca FH, Souza-Filho ZA, Giovanini A, Rubin MR, Kuenzer RF, Reese FB, Araujo LM (2008) The influence of porosity on the integration histology of two polypropylene meshes for the treatment of abdominal wall defects in dogs. Hernia 12:45–49

    Article  PubMed  CAS  Google Scholar 

  39. Vavrík J, Foltynová V, Vítková I, Adámek S, Poucková P (2000) Changes in abdominal wall after mesh implantation in rats. Med Sci Monit 6:476–479

    PubMed  Google Scholar 

  40. Kapan S, Kapan M, Goksoy E, Karabicak I, Oktar H (2003) Comparison of PTFE, pericardium bovine and fascia lata for repair of incisional hernia in rat model, experimental study. Hernia 7:39–43

    PubMed  CAS  Google Scholar 

  41. Dubay DA, Wang X, Kuhn MA, Robson MC, Franz MG (2004) The prevention of incisional hernia formation using a delayed-release polymer of basic fibroblast growth factor. Ann Surg 240:179–186

    Article  PubMed  Google Scholar 

  42. DuBay DA, Wang X, Adamson B, Kuzon WM Jr, Dennis RG, Franz MG (2006) Mesh incisional herniorrhaphy increases abdominal wall elastic properties: A mechanism for decreased hernia recurrences in comparison with suture repair. Surgery 140:14–24

    Article  PubMed  Google Scholar 

  43. Burger JW, Halm JA, Wijsmuller AR, ten Taa S, Jeekel J (2006) Evaluation of new prosthetic meshes for ventral hernia repair. Surg Endosc 20:1320–1325

    Article  PubMed  CAS  Google Scholar 

  44. Butler CE, Navarro FA, Orgill D (2001) Reduction of abdominal adhesions using composite collagen-GAG implants for ventral hernia repair. J Biomed Mater Res (Appl Biomater) 58:75–80

    Article  CAS  Google Scholar 

  45. Butler CE, Prieto VG (2004) Reduction of adhesions with composite AlloDerm/Polypropylene mesh implants for abdominal wall reconstruction. Plast Reconstr Surg 114:464–473

    Article  PubMed  Google Scholar 

  46. Johnson EK, Hoyt CH, Dinsmore RC (2004) Abdominal wall hernia repair: a long-term comparison of Sepramesh and Dualmesh in a rabbit hernia model. Am Surg 70:657–661

    PubMed  Google Scholar 

  47. Demir U, Mihmanli M, Coskun H, Dilege E, Kalyoncu A, Altinli E, Gunduz B, Yilmaz B (2005) Comparison of prosthetic materials in incisional hernia repair. Surg Today 35:223–227

    Article  PubMed  Google Scholar 

  48. Junge K, Rosch R, Klinge U, Saklak M, Klosterhalfen B, Peiper C, Schumpelick V (2005) Titanium coating of a polypropylene mesh for hernia repair: effect on biocompatibility. Hernia 9:115–119

    Article  PubMed  CAS  Google Scholar 

  49. Junge K, Rosch R, Krones CJ, Klinge U, Mertens PR, Lynen P, Schumpelick V, Klosterhalfen B (2005) Influence of polyglecaprone 25 (Monocryl) supplementation on the biocompatibility of a polypropylene mesh for hernia repair. Hernia 9:212–217

    Article  PubMed  CAS  Google Scholar 

  50. Gobin AS, Butler CE, Mathur AB (2006) Repair and regeneration of the abdominal wall musculofascial defect using silk fibroin-chitosan blend. Tissue Eng 12:3383–3394

    Article  PubMed  CAS  Google Scholar 

  51. Petter-Puchner AH, Fortelny R, Mittermayr R, Öhlinger W, Redl H (2005) Fibrin sealing versus stapling of hernia meshes in an onlay model in the rat. Hernia 9:322–329

    Article  PubMed  Google Scholar 

  52. Massaron S, Bona S, Fumagalli U, Valente P, Rosati R (2007) Long-term sequelae after 1311 primary inguinal hernia repairs. Hernia 12:57–63

    Article  PubMed  Google Scholar 

  53. Peiper C, Junge K, Klinge U, Strehlau E, Öttinger A, Schumpelick V (2006) Is there a risk of infertility after inguinal mesh repair? Experimental studies in the pig and the rabbit. Hernia 10:7–12

    Article  PubMed  Google Scholar 

  54. Beets GL, Mameren H, Go PMNYH (1998) Long-term foreign body reaction to preperitoneal polypropylene mesh in the pig. Hernia 2:153–155

    Article  Google Scholar 

  55. Stephenson BM (2003) Complications of open groin hernia repairs. Surg Clin North Am 83:1255–1278

    Article  PubMed  Google Scholar 

  56. Shukla VK, Mongha R, Gupta N, Chauhan VS (2005) Incisional hernia—comparison of mesh repair with Cardiff repair: a university hospital experience. Hernia 9:238–241

    Article  PubMed  CAS  Google Scholar 

  57. Israelsson LA, Smedberg S, Montgomery A, Nordin P, Spangen L (2006) Incisional hernia repair in Sweden 2002. Hernia 10:258–261

    Article  PubMed  CAS  Google Scholar 

  58. Agrawal A, Avill R (2005) Mesh migration following repair of inguinal hernia: a case report and review of literature. Hernia 10:79–82

    Article  PubMed  Google Scholar 

  59. Dieter RA (1999) Mesh plug migration into scrotum: a new complication of hernia repair. Int Surg 84:57–59

    PubMed  Google Scholar 

  60. Fawole AS, Chaparala RP, Ambrose NS (2005) Fate of the inguinal hernia following removal of infected prosthetic mesh. Hernia 10:58–61

    Article  PubMed  Google Scholar 

  61. McDermott MK, Isayeva IS, Thomas TM, Lee AS, Lucas AD, Witkowski CN, Hutter JC (2005) Characterization of the structure and properties of authentic and counterfeit polypropylene surgical mesh. Hernia 10:131–142

    Article  Google Scholar 

  62. Harrell AG, Novitsky YW, Kercher KW, Foster M, Burns JM, Kuwada TS, Heniford BT (2006) In vitro infectability of prosthetic mesh by methicillin-resistant Staphylococcus aureus. Hernia 10:120–124

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

We are grateful to Dr. Matti Laato, Turku University Central Hospital, for critical reading of the manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R. Penttinen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Penttinen, R., Grönroos, J.M. Mesh repair of common abdominal hernias: a review on experimental and clinical studies. Hernia 12, 337–344 (2008). https://doi.org/10.1007/s10029-008-0362-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-008-0362-4

Keywords

Navigation