• Abdominal wall
• Biomechanics
• Hernia
• Mesh
• Pig
• Prevention

• Animals
• Abdominal Wall/surgery
• Biomechanical Phenomena
• Surgical Mesh
• Swine
• Mechanical Phenomena
• Materials Testing
• Sutures

• antibacterial materials
• antimicrobial sutures
• atomic layer deposition
• bacterial adherence
• biofilm
• surgical site infection
• vanadium doped titanium dioxide

• Anti-Bacterial Agents/chemistry
• Sutures/microbiology
• Coated Materials, Biocompatible/chemistry
• Titanium/chemistry
• Surgical Wound Infection/prevention & control
• Materials Testing
• Polypropylenes/chemistry
• Surface Properties
• Aluminum Oxide/chemistry
• Escherichia coli/drug effects
• Humans
• Nanostructures/chemistry

• Bibliometric analysis
• Citation
• Incisional hernia
• Progression
• Trend

• Humans
• Bibliometrics
• Europe
• Germany
• Herniorrhaphy/adverse effects
• Incisional Hernia/surgery
• Observational Studies as Topic
• United States
• Randomized Controlled Trials as Topic

• ZKX18052 Medical Science and Technology Development Foundation, Nanjing Municipality Health Bureau

• anatomy
• diseases
• medical research

• Humans
• Female
• Middle Aged
• Male
• Hernia, Inguinal/surgery
• Herniorrhaphy/methods
• Surgical Mesh
• Endoscopy
• Hernia, Ventral/surgery
• Laparoscopy/methods
• Treatment Outcome

• WK2021F01 the Young and middle-aged Scientific Research Fund of Wannan Medical College
• 2022AH051248 the Natural Science Research Project of Universities in Anhui Province
• WK2022ZF06 the Key project scientific research fund of Wannan Medical College
• WK2020ZF12 the Key project scientific research fund of Wannan Medical College

• Biological
• Biosynthetic
• Contaminated
• Hernia
• Mesh
• Surgery

• Humans
• Hernia, Ventral/surgery
• Treatment Outcome
• Herniorrhaphy/adverse effects
• Herniorrhaphy/methods
• Surgical Wound Infection/surgery
• Abdominoplasty/adverse effects
• Surgical Mesh/adverse effects
• Recurrence
• Retrospective Studies

• Humans
• Retrospective Studies
• Quality of Life
• Herniorrhaphy/methods
• Prospective Studies
• Treatment Outcome
• Hernia, Ventral/surgery
• Incisional Hernia/surgery
• Surgical Mesh
• Recurrence
• Randomized Controlled Trials as Topic

• FFF
• PCL
• biodegradable meshes
• melt electrospinning writing prototype
• pelvic organ prolapse

Background

Synthetic mesh is the most efficient way to repair groin hernias. However, many patients in low and middle-income countries cannot afford the above-mentioned mesh. This study's goal was to describe the mosquito net mesh's (MNM) safety, viability, complications, and recurrence rate in hernioplasty done in rural populations.

Material and methods

This study was a single-centre, prospective, descriptive study, conducted in patients >18 years of age, of either gender, with unilateral or bilateral primary inguinal hernias (reducible/irreducible/bilateral hernia), admitted for elective or emergency open inguinal hernia mesh repair. The surgery was performed using reasonably priced (affordable to people of low socioeconomic status) polyethylene mosquito net mesh, which was cut into 8x16 cm rectangles and wrapped in two sealed plastic bags. They were sterilised using the ethylene oxide sterilisation (EtO) method. The type of hernia (unilateral or bilateral), post-operative pain, and complications were noted.

Results

Among 400 study participants, the incidence of inguinal hernia was highest in the 60-79 year age group (51.5%). Direct inguinal hernia (67.5 %) was higher compared to indirect inguinal hernia (32.5 %). While a majority of the participants had a hernia on the right side (50%), 164 patients (41%) had a hernia on the left side, and 36 patients (9%) had a bilateral inguinal hernia. The average operative time for unilateral inguinal hernia was 73.96 minutes and for bilateral inguinal hernia was 106.66 minutes. Out of 400 patients, 355 patients (88.75%) had no complications. Among the postoperative patients, 14 patients (3.5%) experienced surgical site infection; 9 patients (2.25%) experienced headache; 5 patients (1.25%) experienced hematoma; 12 patients (3%) experienced urinary retention; and 5 patients (1.25%) experienced testicular pain. The average hospital stay of patients was 4.25 days. Patients returned to their daily activities and employment in an average of 7.29 days. The market cost of a single standard polypropylene mesh was Rs.1,660/-. For making a single mosquito net mesh of the same size, we had an expenditure of Rs. 11.83/- including the cost of sterilization. In this study, 382 patients (95.5%) gave us good feedback, 11 patients (2.75) gave satisfactory feedback, and 7 patients (1.75%) gave excellent feedback.

Conclusion

In environments with limited resources, using mosquito net mesh for hernioplasty is reasonable, acceptable, doable, and economical.

• Degradation
• Hernia
• Mechanical strain
• Mesh
• Polypropylene
• Reactive oxygen species (ROS)

• Hernia
• Humans
• Materials Testing
• Polypropylenes/chemistry
• Prostheses and Implants
• Surgical Mesh/adverse effects

• P20 GM121342 NIGMS NIH HHS
• R41 DK120168 NIDDK NIH HHS
• P20GM121342 NIH HHS

• 3D printing
• alginate
• drug release
• mechanical behavior
• surgical mesh
• waterborne-polyurethane

Abdominal hernia repair using prosthetic materials is among the surgical interventions most widely performed worldwide. These materials, or meshes, are implanted to close the hernial defect, reinforcing the abdominal muscles and reestablishing mechanical functionality of the wall. Meshes for hernia repair are made of synthetic or biological materials exhibiting multiple shapes and configurations. Despite the myriad of devices currently marketed, the search for the ideal mesh continues as, thus far, no device offers optimal tissue repair and restored mechanical performance while minimizing postoperative complications. Additive manufacturing, or 3D-printing, has great potential for biomedical applications. Over the years, different biomaterials with advanced features have been successfully manufactured via 3D-printing for the repair of hard and soft tissues. This technological improvement is of high clinical relevance and paves the way to produce next-generation devices tailored to suit each individual patient. This review focuses on the state of the art and applications of 3D-printing technology for the manufacture of synthetic meshes. We highlight the latest approaches aimed at developing improved bioactive materials (e.g., optimizing antibacterial performance, drug release, or device opacity for contrast imaging). Challenges, limitations, and future perspectives are discussed, offering a comprehensive scenario for the applicability of 3D-printing in hernia repair.

• 3D-printing
• additive manufacturing
• bioactive mesh
• hernia repair
• mesh material
• prosthesis

Previously, inguinal hernia surgery was based exclusively on repairing the abdominal wall defects using the patient's own tissues, which were put in contact with and tensioned to recalibrate the natural orifices. At present, inguinal hernia surgery is based almost solely on mounting an allograft, which has the role of strengthening the weakened groin region that allowed the herniation. This modern method of operation on inguinal hernia can be performed in a classic or laparoscopic manner. The mesh is made of polypropylene, which is a polymer of cyclic hydrocarbons. The aim of the present study was to evaluate the effectiveness, biocompatibility, as well as the immediate and long-term complications in textile allografts used in open surgery of inguinal hernia repair. Another aim was to demonstrate once again the superiority of low-weight meshes with large pores by decreasing the number of complications caused by the synthetic material used, but also by a decrease in the tension on the tissues to which it was fixed. The present study included 255 cases submitted to inguinal hernia surgery. Only 1.5% required immediate reintervention before discharge to evacuate hematoma. The short duration of hospitalization, the quality-price ratio, the good postoperative results, as well as the rapid socio-professional reintegration, render the use of polypropylene mesh in inguinal hernia surgery very attractive for patients.

• allografts
• complications
• inguinal hernia
• one-day surgery
• polypropylene mesh

Biomaterials and their applications are perhaps among the most dynamic areas of research within the field of biomedicine. Any advance in this topic translates to an improved quality of life for recipient patients. One application of a biomaterial is the repair of an abdominal wall defect whether congenital or acquired. In the great majority of cases requiring surgery, the defect takes the form of a hernia. Over the past few years, biomaterials designed with this purpose in mind have been gradually evolving in parallel with new developments in the different surgical techniques. In consequence, the classic polymer prosthetic materials have been the starting point for structural modifications or new prototypes that have always strived to accommodate patients’ needs. This evolving process has pursued both improvements in the wound repair process depending on the implant interface in the host and in the material’s mechanical properties at the repair site. This last factor is important considering that this site—the abdominal wall—is a dynamic structure subjected to considerable mechanical demands. This review aims to provide a narrative overview of the different biomaterials that have been gradually introduced over the years, along with their modifications as new surgical techniques have unfolded.

• Polypropylene
• meshes
• polytetrafluoroethylene

• biological mechanism
• biomechanics-matched
• integration-enhanced
• macrophage-mediated
• mesh functionalization
• strategy

Precise visualization of meshes and their position would greatly aid in mesh shrinkage evaluation, hernia recurrence risk assessment, and the preoperative planning of salvage repair. Lightweight (LW) meshes are able to preserve abdominal wall compliance by generating less post-implantation fibrosis and rigidity. However, conventional 3D imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) cannot visualize the LW meshes. Patients sometimes have to undergo a second-look operation for visualizing the mesh implants. The goal of this work is to investigate the potential advantages of Automated 3D breast ultrasound (ABUS) pore texture analysis for implanted LW hernia mesh identification.

In vitro, the appearances of four different flat meshes in both ABUS and 2D hand-held ultrasound (HHUS) images were evaluated and compared. In vivo, pore texture patterns of 87 hernia regions were analyzed both in ABUS images and their corresponding HHUS images.

In vitro studies, the imaging results of ABUS for implanted LW meshes are much more visualized and effective in comparison to HHUS. In vivo, the inter-class distance of 40 texture features was calculated. The texture features of 2D sectional plans (axial and sagittal plane) have no significant contribution to implanted LW mesh identification. Significant contribution was observed in coronal plane. However, since the mesh may have spatial variation such as shrinkage after implantation surgery, the inter-class distance of 3D coronal plane pore texture features are bigger than 2D coronal plane, so the contribution of 3D coronal plane pore texture features are more valuable than 2D coronal plane for implanted LW mesh identification. The use of 3D pore texture features significantly improved the robustness of the identification method in distinguishing between LW mesh and fascia.

An innovative new ABUS provides additional pore texture visualization, by separating the LW mesh from the fascia tissues. Therefore, ABUS has the potential to provides more accurate features to characterize pore texture patterns, and ultimately provide more accurate measures for implanted LW mesh identification.

• ABUS
• Abdominal wall hernia
• Implanted mesh identification
• LW mesh
• Pore texture analysis

A parastomal hernia is a common complication following stoma surgery. Due to the large number of hernial relapses and other complications, such as infections, adhesion to the intestines, or the formation of adhesions, the treatment of hernias is still a surgical challenge. The current standard for the preventive and causal treatment of parastomal hernias is to perform a procedure with the use of a mesh implant. Researchers are currently focusing on the analysis of many relevant options, including the type of mesh (synthetic, composite, or biological), the available surgical techniques (Sugarbaker’s, “keyhole”, or “sandwich”), the surgical approach used (open or laparoscopic), and the implant position (onlay, sublay, or intraperitoneal onlay mesh). Current surface modification methods and combinations of different materials are actively explored areas for the creation of biocompatible mesh implants with different properties on the visceral and parietal peritoneal side. It has been shown that placing the implant in the sublay and intraperitoneal onlay mesh positions and the use of a specially developed implant with a 3D structure are associated with a lower frequency of recurrences. It has been shown that the prophylactic use of a mesh during stoma formation significantly reduces the incidence of parastomal hernias and is becoming a standard method in medical practice.

• biocompatibility
• hernia repair
• parastomal hernia
• prevention
• surgical mesh

• Biologic
• Decellularized extracellular matrix
• Hernia repair
• Mesh repair materials
• Synthetic

• Acrylic Resins/metabolism
• Animals
• Biocompatible Materials/chemistry
• Disease Models, Animal
• Herniorrhaphy/methods
• Humans
• Sheep
• Surgical Mesh/standards

• Fully absorbable
• Implant
• Pelvic organ prolapse
• Poly-4-hydroxybutyrate
• Vaginal fibroblast

• light strengthened polypropylene endoprosthesis
• middle and large ventral hernia
• quality of life

• Flank hernia
• Iliac hernia
• Lateral bulge
• Lateral hernia
• Lumbar hernia
• Transversal incisional hernia

• Abdominal wall repair
• Bioprostheses
• Collagen mesh
• Hernia repair
• Mesh repair
• Poly-4-hydroxybutyrate (P4HB)

• biomechanics
• inflammatory response
• lightweight titanium polypropylene mesh
• polypropylene mesh
• sheep model

• Adhesion
• Hernia
• Poly(ester urea)s
• Soft-tissue

• Adverse events
• Anatomical success
• Composite outcome
• Native tissue repair
• Partially absorbable mesh
• Pelvic organ prolapse
• Primary

• Absorbable Implants/adverse effects
• Aged
• Female
• Follow-Up Studies
• Gynecologic Surgical Procedures/adverse effects
• Gynecologic Surgical Procedures/methods
• Humans
• Middle Aged
• Pelvic Organ Prolapse/surgery
• Postoperative Complications/etiology
• Reoperation
• Sexual Behavior
• Surgical Mesh/adverse effects
• Sutures
• Treatment Outcome
• Vagina/surgery

• Ethicon

• Adhesives
• Animals
• Collagen Type I/metabolism
• Collagen Type III/metabolism
• Cyanoacrylates
• Foreign-Body Reaction/pathology
• Herniorrhaphy
• Macrophages
• Materials Testing
• Polypropylenes
• Rabbits
• Surgical Mesh
• Sutures

• Ministerio de Economía y Competitividad

• abominal wall repair
• carbodiimide cross-linking
• cholecyst-derived extracullar matrix
• mesh stretching
• rabbit animal model

• Anchor
• Hernia
• Mesh
• Repair
• Stress
• Suture
• Tension

Biological compatibility, in terms of implantation of foreign mesh material in hernia surgery, still needs experimental investigation. The present study develops an experimental model using human peritoneum to study the integration between tissue and different mesh material. The ex vivo model using peritoneal tissue was studied with different mesh material, and integration was monitored over time using microscopy. The peritoneal model could be kept viable in culture for several weeks. Cell migration was seen after 7-10 days in culture and could be further monitored over several weeks. The use of a human artificial model environment enabling the investigation of tissue/mesh integration has, to our knowledge, not been described previously. This proof-of-concept model was developed for the investigation of peritoneal biology and the integration between tissue and different mesh material. It has the potential to be useful in studies on other important biological mechanisms involving the peritoneum.

Summary: This study developed a human experimental model for long-term studies using peritoneal tissue to evaluate integration with different materials, such as synthetic meshes.

• Biocompatibility
• Experimental model
• Mesh
• Peritoneal tissue
• Peritoneum
• Synthetic mesh

• abdominal wall
• animal model
• biaxial testing
• incisional hernia
• preclinical model
• recurrent hernia

To evaluate the impact of design features of the synthetic mid-urethral slings on tissue integrity and inflammatory responses.

In total 30 female Sprague-Dawley rats were implanted with type I monofilamentous, macroporous polypropylene meshes: Gynecare TVT-Obturator tape^® (Ethicon Inc., Johnson & Johnson, Somerville, NJ, USA) and I-STOP^® (CL Medical Inc., Lyon, France). All animal groups were sacrificed at set time intervals – 6 weeks, 3 months, 6 months, 9 months and 12 months – and the abdominal wall was harvested with mesh strips for histological evaluation.

All mesh strips appeared to be well incorporated into the abdominal wall, and no signs of shrinkage was noticed. All specimens showed a thin/delicate, loose, fibrous interface between the synthetic graft plate and abdominal wall, along with mild inflammatory reactions from 6 weeks to 12 months.

Both mesh brands induced comparable, minimal foreign body reactions and integrated well into the host tissues despite differences in architectural features. TVT-O^® and I-STOP^® evoked similar low-grade inflammatory responses up to 12 months in this animal model.

Structural differences and architectural features of polypropylene slings used in this study have had no impact on tissue integrity and inflammatory responses.

• I-STOP
• TVT
• histological assessment
• inflammatory response
• mid-urethral sling
• tissue reaction

• Biocompatibility
• Biodegradation
• Mesh
• Polylevolactic acid

• anti-inflammatory coating
• hernia
• histology
• oxidative stress
• tocopherol

• Citric acid
• Hernia
• Hernia mesh
• Hernia prosthesis
• Hernia repair

• R01 CA182670 NCI NIH HHS
• R01 EB012575 NIBIB NIH HHS
• R01 HL118498 NHLBI NIH HHS