Evolution and advances in laparoscopic ventral and incisional hernia repair

Table 3 Advantages and disadvantages of newly developed meshes

Name	Materials	Properties	Current research
BioA® Tissue Reinforcement by Gore®[36,37]	3D matrix copolymer of polyglycolic acid and trimethyl carbonate	Absorbed in 6 mo	Prospective, observational study (NCT01325792) to evaluate single-staged open ventral incisional hernia repair with midline reinforcement in clean contaminated and contaminated wounds. Early one-year results demonstrated a hernia recurrence rate of 14% and an 18% infection rate[36]
TIGR® Matrix by Novus Scientific[38]	Knit mesh of fast absorbing and slow absorbing glycolide, lactide, and trimethylene carbonate fibers	First fiber retains strength for 1-2 wk	One case report of onlay use for open ventral hernia repair[38]
		Second fiber retains strength for 6-9 mo	Currently three-year safety and performance study showing use for inguinal hernia repairs in humans[40]
		Stimulates neovascularization and a high level of type I collagen ingrowth
		Absorbed in 3 yr
Phasix™ mesh by Bard[39]	Monofilament, knit mesh of poly-4-hydroxybutyrate	Minimal absorption in 12-26 wk	Launched in 2013 and currently there are no published results in human subjects
		Porcine model shows 18% strength than natural abdominal wall at 48 wk
		Manufacturer claims hernia repair support for 12-18 mo
Titanized mesh[41]	PP mesh with relatively inert titanium coating	Retains strength of PP mesh	Lower analgesic use (1.6 d vs 6.1 d, P < 0.001) and a quicker return to baseline activity (6.9 d vs 9.7 d, P < 0.001) when compared to parietex mesh. Also less postoperative pain at 1 mo, but no difference at 6 mo
		Titanium retards inflammation and decreases foreign body reaction[42]
Progrip by Covidien[43]	Self gripping PP mesh with small, absorbable hooks	Promotes abdominal wall adhesion, prevents migration, and decreases the number of tack or sutures fixation points	Has been used in laparoscopic inguinal, ventral, and incisional hernia repairs
			One study asserts less postoperative pain after laparoscopic inguinal hernia repair, but another shows no difference with open repair[43,44]
			Operative times may be less

PP: Polyethylene.