Recently there has been a rapid development in mesh technology. Many different approaches have been taken to develop the ideal hernia repair mesh:
Composition - Traditional meshes are made from polypropylene. This a synthetic polymer which is incorporated in modern meshes with a variable amount of "absorbable" synthetic polymers. The advantage with modern mesh materials is that the amount of foreign material within the patient diminishes with time once the body has formed scar tissue around the repair.
Weave size - Larger weaves with more space between the fibres allow the natural scar formation to easily penetrate the mesh. This results in a more robust repair. Very small holes between the fibres made it difficult for the body to incorporate the mesh and the repair was more dependent on the integrity of the sutures to hold the mesh in place.
Rigidity - The more rigid the mesh, the easier the operation; as the mesh unfolds easily within the abdomen and the mesh is more easily manipulated into position. On the other hand, stiff meshes may be more easily felt, especially by thin patients. This appears to be less of a problem in laparoscopic hernia repairs
Non-adherent coatings -These coatings reduce the incidence of adhesion between the mesh and the abdominal contents. These meshes are particularly appropriate for the repair of incisional herniae.
Shape - Newer meshes are available for TEP hernia repair which are shaped to fit the pelvis. This eliminates the need for fixation of the mesh and reduces the possibility of nerve injury.