Improving Outcomes in Hernia Repair by the use of Light Meshes

Excerpt

Weyhe and colleagues have made a timely and scholarly contribution to the debate about the use of different types of mesh in hernia repair [1]. Much of the current advice meted out at national and international meetings is industry-based dogma rather than evidence-based advice, and this new perspective is welcome. Much the same arguments are applicable to the new biological meshes, for which there are limited clinical data and only short-term follow-up [2]. The theoretical scar plate and inflexible abdominal wall that is said to result from “heavyweight” (a misnomer; anything less may not be strong enough for incisional hernia repair [3]) meshes has been disproved. In the study of Conze and colleagues [4] analyzed by Weyhe, unpublished data from 87 patients appearing in the Clinical Trial Report showed an increase in radii (see Figure 39, reproduced below) from baseline to month 24 with no difference between Vypro (a very lightweight mesh) and polypropylene (heavyweight) meshes.

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