Permanent Prosthetics: Polypropylene, Polyester, ePTFE, and Hybrid Mesh

While primary suture repair remains an option for select hernias, mesh prosthetics have shown to greatly reduce the incidence of hernia recurrence [1, 2]. Because of this significant benefit, the vast majority of modern hernia repairs utilize some form of mesh reinforcement. Surgeons strive to find and utilize the “ideal” mesh. Up until relatively recently, little has changed over the last half century with regard to the evolution of mesh. Dr. Francis Usher popularized the use of polypropylene mesh in the 1950s, [3] while Dr. Rene Stoppa and Dr. Jean Rives published their use of polyester meshes in the 1980s, among other great surgeons using various mesh prosthetics [4]. Currently, polypropylene and polyester remain the most commonly utilized materials in modern meshes, with a reduction in the use of expanded polytetrafluorethylene (ePTFE). Newer synthetic materials have been developed, including polyvinylidene fluoride (PVDF); however, long-term data is still being accrued. A variety of composite and hybrid meshes have also been developed that share characteristics of different materials to aid in mesh integration, impede adhesion formation, and/or provide some degree of resorption.