Hernia repair techniques: a comparative analysis of mesh types


  • Mohammed F. Qaffas Department of General Surgery, Al Thager Hospital, Jeddah, Saudi Arabia
  • Ibrahim Y. Alnami College of Medicine, Jazan University, Jazan, Saudi Arabia
  • Mariam S. Barni College of Medicine, Sechenov University, Moscow, Russia
  • Ghadeer E. Tammam College of Medicine, Sechenov University, Moscow, Russia
  • Mohammed A. Alharthi Ministry of Health, Jeddah, Saudi Arabia
  • Abdulaziz K. Alharbi College of Medicine, Taibah University, Medina, Saudi Arabia
  • Khaled H. Alnhas College of Medicine, Al-Rayan Colleges, Medina, Saudi Arabia
  • Mutasem S. Kutbi Transformation Management, Makkah Health Cluster, Mecca, Saudi Arabia
  • Abdulmohsen A. Almuhaysin College of Medicine, Medical University of Lodz, Lodz, Poland
  • Hamed S. Alshamrani Department of Operation Room, AlQunfudah General Hospital, Al Qunfudah, Saudi Arabia
  • Asma M. Asiri College of Medicine, Almaarefa University, Riyadh, Saudi Arabia




Hernia, Open hernia repair, Laparoscopic repair, Polypropylene mesh, Polyester mesh, Biological mesh, Composite mesh, 3D mesh


A hernia is a condition characterized by the protrusion of an internal organ, often part of the intestine, through a weakened area in the surrounding muscle and tissue. Surgical intervention is the primary treatment option for most hernias, with procedures known as herniorrhaphy or hernioplasty. Traditional open surgery involves a sizable abdominal incision, granting direct access to the herniated tissue. Alternatively, minimally invasive laparoscopic surgery utilizes small incisions and specialized instruments, including a camera, for repair. Synthetic or biological mesh is frequently employed to reinforce weakened muscle or tissue, reducing hernia recurrence risk. Mesh is integral to hernia treatment, providing critical reinforcement and enabling tension-free closure. This article's rationale lies in the necessity for a comprehensive comparative analysis of hernia repair techniques, with a particular focus on the influence of different mesh types in abdominal hernia surgery. This research, initiated on 17 October 2023, involved an exhaustive review of existing literature via databases like PubMed, Web of Science, and Cochrane, employing a broad range of medical terminology combinations. The management of hernias has evolved significantly, and open hernia repair, especially using the Shouldice technique, remains valuable when the mesh is unavailable or undesired. Modern tension-free repair techniques, such as Lichtenstein and plug and patch, provide similar outcomes. Laparoscopic hernia repair, despite the longer surgery duration, offers advantages in terms of recurrence, recovery, and postoperative discomfort. Mesh selection is vital, with options like polypropylene, polyester, composite, biological, and 3D offering tailored attributes. The choice should consider patient history, hernia type, and surgeon expertise, necessitating awareness of evolving techniques and materials for optimal outcomes in hernia repair.


UK National Health Service. Hernia. 2023. Available at: https://www.nhs.uk/conditions/hernia/. Accessed on 09 August 2023.

HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018;22(1):1-165.

M. The Art and Science of Abdominal Hernia. BoD–Books on Demand. 2022.

Marcy HO. The anatomy and surgical treatment of hernia. Ann Surg. 1893;18:678-81.

Bittner R, Köckerling F, Fitzgibbons Jr RJ, LeBlanc KA, Mittal SK, Chowbey P. Laparo-endoscopic hernia surgery: evidence based clinical practice. Springer. 2018.

LeBlanc KA, Kingsnorth A, Sanders DL. Management of abdominal hernias. Springer. 2018.

LeBlanc K. Proper mesh overlap is a key determinant in hernia recurrence following laparoscopic ventral and incisional hernia repair. Hernia. 2016;20(1):85-99.

Vatansev C, Belviranli M, Aksoy F, Tuncer S, Sahin M, Karahan O. The Effects of Different Hernia Repair Methods on Postoperative Pain Medication and CRP Levels. Surg Laparosc Endosc Percutaneous Techniques. 2002;12(4):243-6.

Amato B, Moja L, Panico S, Persico G, Rispoli C, Rocco N, Moschetti I. Shouldice technique versus other open techniques for inguinal hernia repair. Cochrane Database Syst Rev. 2012;4:CD001543.

AlMarzooqi R, Tish S, Huang LC, Prabhu A, Rosen M. Review of inguinal hernia repair techniques within the Americas Hernia Society Quality Collaborative. Hernia. 2019;23(3):429-38.

Köckerling F, Simons MP. Current Concepts of Inguinal Hernia Repair. Visceral Med. 2018;34(2):145-50.

Zhao G, Gao P, Ma B, Tian J, Yang K. Open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Ann Surg. 2009;250(1):35-42.

Li J, Ji Z, Li Y. Comparison of mesh-plug and Lichtenstein for inguinal hernia repair: a meta-analysis of randomized controlled trials. Hernia. 2012;16:541-8.

Chung R, Rowland D. Meta-analyses of randomized controlled trials of laparoscopic vs conventional inguinal hernia repairs. Surg Endosc. 1999;13:689-94.

O'Reilly EA, Burke JP, O'Connell PR. A meta-analysis of surgical morbidity and recurrence after laparoscopic and open repair of primary unilateral inguinal hernia. Ann Surg. 2012;255(5):846-53.

Schmedt C, Sauerland S, Bittner R. Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc Other Intervent Techniques. 2005;19:188-99.

McCormack K, Scott N, Go PM, Ross SJ, Grant A. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev. 2003;1.

Bittner R, Schwarz J. Inguinal hernia repair: current surgical techniques. Langenbeck's Arch Surg. 2012;397(2):271-82.

Brown C, Finch J. Which mesh for hernia repair? Ann Royal Coll Surgeons Engl. 2010;92(4):272-8.

Bilsel Y, Abci I. The search for ideal hernia repair; mesh materials and types. Int J Surg. 2012;10(6):317-21.

Langenbach MR, Sauerland S. Polypropylene versus Polyester Mesh for Laparoscopic Inguinal Hernia Repair: Short-Term Results of a Comparative Study. Surg Sci. 2013;4(1):6.

Majumder A, Winder JS, Wen Y, Pauli EM, Belyansky I, Novitsky YW. Comparative analysis of biologic versus synthetic mesh outcomes in contaminated hernia repairs. Surgery. 2016;160(4):828-38.

Rashid T, Reshi FA, Mir IS. A comparative study of three-dimensional mesh (3D mesh) and polypropylene mesh in laparoscopic inguinal hernia repairs in adults. Int Surg J. 2018;5(1):174-80.

Lorenz R, Arlt, Conze J. Shouldice standard 2020: review of the current literature and results of an international consensus meeting. Hernia. 2021;25:3.

Mishra R. Laparoscopic repair of inguinal hernia. Laparoscopy Hospital, New Delhi, India. 2003. Available at: http://www laparoscopyhospital com. Accessed on 09 August 2023.




How to Cite

Qaffas, M. F., Alnami, I. Y., Barni, M. S., Tammam, G. E., Alharthi, M. A., Alharbi, A. K., Alnhas, K. H., Kutbi, M. S., Almuhaysin, A. A., Alshamrani, H. S., & Asiri, A. M. (2023). Hernia repair techniques: a comparative analysis of mesh types. International Journal Of Community Medicine And Public Health, 10(12), 5044–5048. https://doi.org/10.18203/2394-6040.ijcmph20233809



Review Articles