Mesh questions and answers

Mesh questions and answers

Mesh questions and answers


I am often asked – “Which mesh do YOU recommend. Which is the best mesh?

In fact here is not one “best” mesh and in practice different types of meshes will be used in different situations.   The physical properties of the mesh are determined by the type of material that the strands are made of, the diameter and strength of the strands and the size of the holes between the strands. The holes or gaps are known as pores.

I like to use a lightweightmesh with large pores

Lightweight: – the early meshes were dense – lots of material with a thick weave. They were over-engineered, much stronger than biological tissue – unneccessarily strong. Too much mesh can cause problems by increasing the amount of local inflammation and generating excessive scar tissue. such as discomfort or actual pain.

Large pore : – pore size, the size of the holes, is important. With large pores, about 3 or 4 mm, there is less scar formation, less tendency for shrinkage of the mesh, and much less likelihood of long term discomfort.

Other FAQs– things you should know.

What is the mesh made of? – usually polypropylene

Does it dissolve? No – it is permanent, and acts as a permanent scaffold for healing.

(but see biological mesh)

How is it attached? I place several fine stitches at the corners to hold it in place in the early stages of healing. These are usually permanent, of the same material as the mesh, but I sometimes use dissolvable stitches.

Is the mesh placed on top of or behind the hernia defect ?

For inguinal hernias – open tension-free technique – between the top and middle layers of the abdominal wall muscle.

In the laparoscopic repair the mesh lies deep – behind all the abdominal wall muscles.