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letter
. 2016 Aug 8;113(31-32):543. doi: 10.3238/arztebl.2016.0543b

A Need for Catching up in Testing Meshes

Thomas Otto *, Dimitri Barski *, Bernhard J Lammers *
PMCID: PMC5012170  PMID: 27581513

At the present time, any categorical recommendation for mesh-based hernia repair can be made only subject to certain caveats (1). Unanswered questions on the biocompatibility of meshes remain, and this on the background of possible physical reactions to foreign bodies, which make later procedures, such as lymphadenectomy, vascular reconstruction, or radical prostatovesiculectomy, difficult or even altogether impossible. Hydrocele, varicocele, spermatic cord irritations, ilioinguinal pain syndromes after mesh implantations are not rare. And why would they be, in view of the occasionally catastrophic results after using the same alloplastic materials in prolapse surgery in women (2).

We currently have an urgent need to catch up in the already widespread use of meshes and require:

  1. A system of tests to ascertain the biocompatibility of meshes (3)

  2. Valid studies before mesh materials are used clinically (4)

  3. A compulsory, cross-disciplinary implant registry for the purpose of evaluating long term effects, such as is already being called for in the federal government’s national strategy process.

Footnotes

Conflict of interest statement

The author declares that no conflict of interest exists.

References

  • 1.Berger D. Evidence-based hernia treatment in adults. Dtsch Arztebl Int. 2016;113:150–158. doi: 10.3238/arztebl.2016.0150. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Klosterhalfen B, Klinge U. Juristische Klagewelle in den USA. In: Otto T, Lammers B, Schumpelick V, editors. Implantate in der Chirurgie - Update 2015. London, Boston: Uni-Med Verlag; 2015. pp. 95–98. [Google Scholar]
  • 3.Gerullis H, Georgas E, Goretzki P, Lammers BJ, Otto T. Evaluation of biocompatibility of alloplastic materials: Development of a tissue culture in vitro test system. Surg Technol Int. 2011;XXI:21–27. [PubMed] [Google Scholar]
  • 4.Gerullis H, Klosterhalfen B, Borós M, et al. IDEAL in meshes for prolapse, urinary incontinence and hernia repair. Surg Innov. 2013;20:502–508. doi: 10.1177/1553350612472987. [DOI] [PubMed] [Google Scholar]

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