Prosthetic Fixation Options

There is a spectrum of mesh fixation options for all hernia repairs. The two main categories include mechanical fixation and adhesive fixation. Key differences between the two modalities include using point fixation of mesh by anchoring it to tissue (mechanical) versus the fixation of the entire surface area of mesh by covering it with a nonpenetrating fixative (adhesive). Selection of one form over the other (or combination use) is dependent on many factors that include operative approach, type of hernia, and the location of mesh placement. Aims of this review are to discuss the biomechanics of fixation and clinical outcomes of these various forms of fixation within the realm of hernia repair.