3. Self-fixating meshes
Some surgeons worry that fixating hernia mesh to the tissue with
sutures, staples or tacks can lead to prolonged post-op pain or surgi-
cal site infections. While those concerns aren't backed by science,
some manufacturers are trying to help docs avoid the situation alto-
gether with self-fixating meshes.
Self-fixating meshes feature a small, hook-like pattern on one side
that lets them attach to the repaired tissue and stay put without tradi-
tional forms of mechanical fixation. This Velcro-like quality makes it
notoriously difficult to handle, says Dr. Ramshaw. "Generally, it's hard-
er to use, especially in laparoscopic cases, because it sticks to every-
thing, though it has gotten better," he says. For those who prefer
mechanical fixation, "it's all about angulation" with the latest tackers
and staplers, says Dr.
Ramshaw.
Laparoscopic devices
that articulate at the
tip let the surgeon
reach difficult areas
inside the abdomen
and fixate mesh more
efficiently and quickly.
Dr. Nguyen says self-
fixating mesh can
work particularly well
near sensitive struc-
tures that make tack-
ing or stapling difficult
or even impossible,
such as laparoscopic
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