Evolution and advances in laparoscopic ventral and incisional hernia repair

Table 1 Advantages and disadvantages of permanent synthetic mesh materials (polyester and polypropylene)

Advantages	Disadvantages
Permanent synthetic mesh, either woven or knit	Risk contraction, chronic inflammation, stiff abdominal wall, chronic pain especially with heavy weight PP
Provides strength by stimulating inflammation and abdominal wall ingrowth	PE with possible higher infection and recurrence vs PP
PE has less contraction than PP	Should not be placed in contact with bowel as inflammatory response increases adhesions to viscera
Lightweight PP has less foreign body response, more pliable, more ingrowth[25]	Increased risk of fistula, bowel obstruction, and re-operative complications[26]
Sometimes able to salvage lightweight mesh after infection due to improved antibiotic penetration[25]	Enterotomy and/or bowel resection upon re-operation are almost four times greater with prior use of mesh, with most of these being uncoated mesh[27]

PE: Polyester; PP: Polypropylene.