Page 35 - World Journal of Laparoscopic Surgery

Laparoscopic Ventral Hernia Repair with Polypropylene Mesh: A Literature Review
Table 2: Some of the common mesh types Contd…
Name Composition Image Name Composition Image
Prolene Polypropylene Marlex Crystalline
polypropylene and high-
density polyethylene
(HDPE)

Ultrapro Polypropylene–
polyglecaprone DualMesh e-PTFE
composite

Tutomesh Bovine pericardium
Parietex Polyester with collagen–
composite polyethylene glycol–
glycerol coating

Sepramesh Polypropylene with
carboxymethylcellulose–
sodium hyaluronate dIscussIon
coating
Hernia repair has to be completed by the placement of a mesh
except in few situations. 12,13 Which type of mesh is the best for
each hernia is a controversial issue. There are different surgeon’s
opinions as well as a large pool of mesh types to select from. These
mesh types differ in composition, coatings, pore size, strength,
Timesh Titanium–polypropylene shrinkage, and methods of fixation. The commonly used mesh
composite types are illustrated in Table 2.
Complications secondary to the presence of mesh do occur
and there is no available mesh type without such a risk. In the
literature, there are reports of different complications associated
with different mesh types. 2,14,15 Among the common complications
are adhesions formation leading to bowel obstruction, fistulization,
Proceed Polypropylene– sinus formation, infection, and hernia recurrence. The development
polydioxanone of complications is sometimes related to the position of the mesh
composite with oxidized rather than to its composition. For example, the PPM triggers the
cellulose coating formation of adhesions, which is beneficial in the peri-peritoneal
position while may be harmful if placed intraperitoneal. 16
Despite the fact that all the case series analyzed in this review
recommended a safe intraperitoneal placement of PPM, none
of them qualify as an acceptable level of evidence. They have in
common limited number of subjects and they vary in follow-up
duration as all had short-term follow-up. The assessment methods
C-Qur Omega-3 fatty acid- were also different between the studies, e.g., Bingener and
coated polypropylene colleagues used ultrasound scan to examine the presence of
intraperitoneal adhesions in their study. 4
In the animal experiments two studies rejected the use
of intraperitoneal PPM while the third one did not give clear
recommendation but concluded that even coated meshes reduce
the incidence of adhesions only in the short-term. Table 2 illustrates
the common types of meshes. The results of animal experiments
Contd… cannot be generalized directly to humans. Beside that they all lack

World Journal of Laparoscopic Surgery, Volume 13 Issue 1 (January–April 2020) 33