Hernia repair is one of the most commonly performed surgical procedures worldwide,with a multibillion dollar global market.Implant design remains a critical challenge for the successful repair and prevention of recurr...Hernia repair is one of the most commonly performed surgical procedures worldwide,with a multibillion dollar global market.Implant design remains a critical challenge for the successful repair and prevention of recurrent hernias,and despite significant progress,there is no ideal mesh for every surgery.This review summarizes the evolution of prostheses design toward successful hernia repair beginning with a description of the anatomy of the disease and the classifications of hernias.Next,the major milestones in implant design are discussed.Commonly encountered complications and strategies to minimize these adverse effects are described,followed by a thorough description of the implant characteristics necessary for successful repair.Finally,available implants are categorized and their advantages and limitations are elucidated,including non-absorbable and absorbable(synthetic and biologically derived)prostheses,composite prostheses,and coated prostheses.This review not only summarizes the state of the art in hernia repair,but also suggests future research directions toward improved hernia repair utilizing novel materials and fabrication methods.展开更多
The Rives-Stoppa technique for ventral hernia repair is commonly utilized due to well-proven outcomes with low overall morbidity. However, this approach is limited by the amount of myofascial advancement and sublay sp...The Rives-Stoppa technique for ventral hernia repair is commonly utilized due to well-proven outcomes with low overall morbidity. However, this approach is limited by the amount of myofascial advancement and sublay space available for a wide mesh overlap. Thus, anterior component separation was developed to allow further myofascial advancement.Some limitations were noted, which led to the subsequent study, utilization, and refinement of the posterior component separation (PCS) technique.PCS continues to demonstrate low hernia recurrence, surgical site occurrences, and improvement in rectus muscle function. Continued adoption of this technique has expanded to minimally invasive approaches for hernia repair. This paper is a comprehensive review of the evolution of PCS, technique, and outcomes.展开更多
基金This work was supported in part by National Institutes of Health awards(EB012575,CA182670,HL118498)National Science Foundation(NSF)awards(DMR1313553,CMMI1266116,CMMI1537008).
文摘Hernia repair is one of the most commonly performed surgical procedures worldwide,with a multibillion dollar global market.Implant design remains a critical challenge for the successful repair and prevention of recurrent hernias,and despite significant progress,there is no ideal mesh for every surgery.This review summarizes the evolution of prostheses design toward successful hernia repair beginning with a description of the anatomy of the disease and the classifications of hernias.Next,the major milestones in implant design are discussed.Commonly encountered complications and strategies to minimize these adverse effects are described,followed by a thorough description of the implant characteristics necessary for successful repair.Finally,available implants are categorized and their advantages and limitations are elucidated,including non-absorbable and absorbable(synthetic and biologically derived)prostheses,composite prostheses,and coated prostheses.This review not only summarizes the state of the art in hernia repair,but also suggests future research directions toward improved hernia repair utilizing novel materials and fabrication methods.
文摘The Rives-Stoppa technique for ventral hernia repair is commonly utilized due to well-proven outcomes with low overall morbidity. However, this approach is limited by the amount of myofascial advancement and sublay space available for a wide mesh overlap. Thus, anterior component separation was developed to allow further myofascial advancement.Some limitations were noted, which led to the subsequent study, utilization, and refinement of the posterior component separation (PCS) technique.PCS continues to demonstrate low hernia recurrence, surgical site occurrences, and improvement in rectus muscle function. Continued adoption of this technique has expanded to minimally invasive approaches for hernia repair. This paper is a comprehensive review of the evolution of PCS, technique, and outcomes.
