Innovations in ventral hernia repair.

There is a renewed interest in the surgical repair of ventral hernias due to new meshes and new techniques to use these meshes. The standard of care for ventral hernia repair, the Rives-Stoppa repair, is now more commonly done in the USA. Originally, only polypropylene mesh (PPM) or polyester meshes were available for this technique and they had to be placed extraperitoneally. With development of the laparoscopic approach for ventral hernia repair using expanded polytetrafluoroethylene (ePTFE), newer coated meshes for intraperitoneal placement were developed. Companies have also combined polypropylene mesh (PPM) and polytetrafluoroethylene (PTFE) into a unique mesh and numerous biologic meshes are being introduced. All of these meshes have led to several new methods for ventral hernia repair (including parastomal hernia) and in those cases where mesh is not indicated, one non-mesh repair, the components separation, has received renewed attention.