Biologic and Absorbable Mesh Options
One of the exciting new developments in hernia surgery is the advent of biologic mesh. This involves the use of human (cadaver) or animal tissue instead of the typical man-made “plastic” mesh used in most procedures. Biologic mesh absorbs into the body, strengthening the body’s natural structures. Because of the possible side effects of permanent mesh, these “natural” options have been studied as the future of hernia repair. However, because of their cost, and the permanent strength of plastic meshes, they will likely never be used for uncomplicated repairs. Indeed, biologic meshes have an unacceptably high recurrence rate for most elective repairs. Biologic meshes are typically reserved for when the surgical field is infected or in cases where the hernia has strangulated and this form of mesh is expected to offer benefits above and beyond traditional mesh.
Absorbable (non-biologic) mesh is built from man-made materials, however it disintegrates over time. Much like a biologic mesh, the inflammation associated with its implantation strengthens the body’s native tissue and builds scar tissue to reinforce the repair. Ideally, once the mesh has dissolved, the repair is near full strength. New absorbable meshes may be fully dissolvable or may incorporate both absorbable and non-absorbable components to minimize discomfort and volume of foreign body material.
Both biologic and absorbable mesh technology is still in its infancy and more data needs to be gathered to understand whether it has a place in uncomplicated hernia repairs. In both cases listed above, the new technology in absorbable mesh may be indicated for certain patients that have a higher risk of complications associated with their hernia repairs. However, it is worth noting that traditional mesh is well tolerated in 90 to 98% of all patients and has been proven effective with decades of research and implementation.
Unless otherwise indicated, we typically repair hernia defects with traditional mesh and reserve biologic and/or absorbable meshes to very specific cases.