mesh seem to be the modern innovation , but what is the impact for developing countries.
Dear George, Mesh made an enormous difference in perticular for Abd wall surgeries.Let me narrate over 3 decades of experience with Mesh.During the Last part of my training in UK way back in 1980 we started using Marlex mesh.Subsequently in India Prolene meshes for overlay repair .In 1990 PTFE were available to bridge the gapand for over lap as well.Then came the ERA of Laparoscopy which revolutionised the hernia surgery by the introduction of Dual ,flexible and shaped meshes.This certainly reduced the incidence of recurrence,wound infection,morbidity, by introducing newer technology.Last few years another another new technique ,Component separation and Retro rectus by open and Lap are practiced as we started understanding the Abdominal wall Anatomy for larger hernia ,again we need a mesh.Now practically no abdominal wall hernia is repaired with out a mesh.Hope I have answered your question.
thank you so much SIR , i did not even know that it has been far as 1980 ,whereas in the most populous country in Africa mesh is a thing of rare use.
The treatment of choise of ventral hernias is prosthetic repair. Since 1982 I perform retro rectus mesh augmentation ( Rives Stoppa procedure). Restroring of midline is the goal of AWRs. When necessary I adopt component separation techniques ( posterior, according to Rosen or to A.Carbonell, or anterior according to F.Carbonell-Tatay). No meshes in contact with abdominal viscera, if possible. When necessary selecting the proper mesh is very important. Many complications from PTFE meshes ( I removed a lot of these meshes...). Laparoscopic mesh only in selected cases.
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