Surgical Technology: Mesh

Mesh Properties

Mesh Material

  • Nonabsorbable
    • Polypropylene (PP) – Most Commonly Used
    • Polyethylene (PE)
    • Expanded Polytetrafluoroethylene (ePTFE)
  • Absorbable
    • Polyglactin 910 (Vicryl)
    • Poly-4-Hydroxybutyrate (P4HB)
    • Polyglycolic Acid (PGA) & Trimethylene Carbonate (TMC)
    • Biologic – Collagen Matrix Promotes Neovascularization & Collagen Deposition
      • Higher Recurrence than Synthetic

Pore Size

  • Microporous: Small Pores < 10 μm
    • Do Not Allow Tissue Incorporation
      • Composite Mesh with a PTFE Coated Layer Against the Bowel Can Prevent Adhesions
    • Filled with Scar Tissue
    • Includes: ePTFE
    • Generally Increased Risk of Infection
  • Macroporous: Large Pores ≥ 75 μm
    • Allows Tissue Incorporation
    • Infiltration of Macrophages, Fibroblasts & Collagen
    • Includes: PP

Weight

  • Heavy-Weight: Weight > 140 g/m2
    • Typically Thicker Polymers & Smaller Pores
    • High Tensile Strength
    • Profound Tissue Reaction with Dense Scarring
  • Medium-Weight: Weight 70-140 g/m2
  • Light-Weight: Weight 35-70 g/m2
    • Typically Thinner Polymers & Larger Pores
    • More Elastic
    • Less Tissue Reaction
    • Lower Risk of Postoperative Pain and Stiffness but May Have a Higher Risk of Recurrence – Still Being Evaluated
  • Ultra-Light-Weight: Weight < 35 g/m2

Brand Names

Bard® Mesh

  • 3DMax (PP)
    • 3-Dimensional Mesh for Laparoscopic Inguinal Hernia Repair (Unilateral Design)
    • Regular & Light-Weight (Large-Pore) Versions
  • Bard (PP)
    • Regular & Soft (Large-Pore) Versions
  • Dulex (ePTFE)
    • Dual Sided
  • Ventralex (PP & ePTFE)
    • Patch & ST Patch Versions
  • Ventralight ST (Anterior Side: Uncoated PP, Posterior Side: Absorbable Hydrogel Barrier)
  • Marlex (PE)
  • OnFlex
    • Regular & Modified Versions
    • Formed for Inguinal Hernias
  • Phasix (P4HB)
    • Regular & ST Versions
    • ST – Refers to Sepra Film Technology (Absorbable Hydrogel Barrier to Prevent Adhesions)

Ethicon® Mesh

  • Prolene (PP)
    • Regular, Soft, 3D Patch (Has Plug That Pulls Back) & Hernia System Versions
    • Hernia System – Has 2 Mesh Layers (Onlay & Underlay) with Connector
  • Ultrapro
    • Advanced, Light-Weight & Hernia System Versions
  • Vicryl (Polyglactin 910)
    • Woven/Knit & Mesh Bag Versions
  • XCM Biologic (Tissue Matrix)
  • Physiomesh
  • Proceed

Gore® Mesh

  • Bio-A (67% PGA: 33% TMC)
  • Dualmesh (ePTFE & Textured CORDUROY Surface)
    • Regular & Plus (Has Antimicrobial Preservation) Versions
  • Gore-Tex (ePTFE)
  • Synecor (PTFE & PGA/TMC)

Medtronic® Mesh

  • Duatene
    • Bilayer Mesh
  • Symbotex
  • Progrip
  • Paritex