Over the last 10 years it has become acknowledged that all abdominal wall hernias should be repaired using mesh. Mesh types can broadly be divided into plastic and biological varieties.
In order to place a mesh in the intra peritoneal space (the space that provides the greatest bio-mechanical strength for repair) and subsequently on the bowel, the mesh needs to have a ‘non stick’ layer on the side facing the bowel.
In our own practice we use the latest generation mesh from Bard that has a unique design allowing for the mesh to keep its lateral integrity thereby providing a robust repair.
We use this mesh for both our open and laparoscopic repairs as it provides the best long term results in terms of reducing recurrence rates.
‘Biological’ mesh is usually derived from animal tissue which is either bovine or porcine in origin. These meshes are resistant to infection and are used in cases where the risk of infection of a plastic mesh is considered too high e.g.
However whilst biological mesh resists infection it is not as strong as plastic and may become degraded over time; therefore it may have higher recurrence rates than plastic mesh.
Our preferred biological mesh is Strattice from Lifecell. We have published extensively on this product and shown exceptional published outcomes.