How is the mesh material selected for laparoscopic inguinal hernia repair?

Updated: Apr 16, 2020
  • Author: Danny A Sherwinter, MD; Chief Editor: Kurt E Roberts, MD  more...
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Answer

The mesh used for the repair must be a permanent material cut to a size large enough to produce a wide overlap beyond the defect’s edges. The choice of material depends on surgeon preference; both lightweight polypropylene and polyester are good choices. The size may range from 5 × 10 cm to 10 × 15 cm. The mesh can either be flat and rectangular or preformed to fit the myopectineal orifice. Although some surgeons prefer anatomic mesh configurations, a flat sheet works just as well and is more cost-effective.

In general, a standard uncoated mesh is used for laparoscopic repairs, because the mesh will be shielded from the intra-abdominal organs by the peritoneum. When the peritoneum is torn and cannot be repaired, coated polypropylene or polyester-based meshes or other meshes approved for intra-abdominal applications (eg, expanded polytetrafluoroethylene [ePTFE]) can be used.

Although further study remains necessary, it appears that lightweight meshes may have some advantages over standard heavyweight polypropylene meshes with regard to the development of postoperative pain and discomfort after inguinal hernia repair. [74, 75, 76, 77, 78]


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