New Insights into the Application of 3D-Printing Technology in Hernia Repair

Abstract

Abdominal hernia repair using prosthetic materials is among the surgical interventions most widely performed worldwide. These materials, or meshes, are implanted to close the hernial defect, reinforcing the abdominal muscles and reestablishing mechanical functionality of the wall. Meshes for hernia repair are made of synthetic or biological materials exhibiting multiple shapes and configurations. Despite the myriad of devices currently marketed, the search for the ideal mesh continues as, thus far, no device offers optimal tissue repair and restored mechanical performance while minimizing postoperative complications. Additive manufacturing, or 3D-printing, has great potential for biomedical applications. Over the years, different biomaterials with advanced features have been successfully manufactured via 3D-printing for the repair of hard and soft tissues. This technological improvement is of high clinical relevance and paves the way to produce next-generation devices tailored to suit each individual patient. This review focuses on the state of the art and applications of 3D-printing technology for the manufacture of synthetic meshes. We highlight the latest approaches aimed at developing improved bioactive materials (e.g., optimizing antibacterial performance, drug release, or device opacity for contrast imaging). Challenges, limitations, and future perspectives are discussed, offering a comprehensive scenario for the applicability of 3D-printing in hernia repair.

Development and Implantation of 3D Anatomically Tailored Polypropylene Mesh for Laparoscopic Inguinal Hernia Repair Designed on the Basis of CT Images (the ILAM Study)

“…In contrast to the described standardized and woven structure shaping process, multiple experimental studies have been carried out using 3D printing to develop new prostheses for hernia repair. [10][11][12] Using fused deposition modeling (FDM), experimental meshes have been fabricated and assessed in various in vivo and in vitro settings. 10 However, 3D printing technology is currently at a developing stage, and none of the materials have shown an optimal balance between weight, microporosity and elasticity.…”

Shape‐Configurable Mesh for Hernia Repair by Synchronizing Anisotropic Body Motion

“…3D printing utilizes a computer‐aided design (CAD) software to transfer a device design into material printing through layer‐by‐layer deposition. [ 6 ] The advantage of our approach is to produce patient‐specific devices using clinical CT and MRI images. [ 37 ] Additionally, 3D printing enables post‐modifications such as drug coating [ 16 ] and cell embedding, [ 38 ] thereby serving as one of the most versatile technologies for a wide range of applications.…”

“…Since the mid-20th century, polypropylene (PP), expanded polytetrafluoroethylene (ePTFE), and polyethylene (PE) have been widely used to produce mesh devices. [6,7] The surgical mesh has evolved to enhance biocompatibility and clinical efficacy by including biological mesh and degradability in addition to diversifying the design parameters (e.g., structure, pore size, density, weight, filament, etc.). [8] Despite continuous progress in the surgical method and mesh performance, insufficient regenerative integration between post-surgery tissue and hernia mesh results in complications such as recurrence, fibrosis, and chronic pain.…”

Antimicrobial Meshes for Hernia Repair: Current Progress and Perspectives

“…In the future, other fabrication techniques such as 3D printing could be employed to develop surgical meshes that are individually tailored to each patient's needs and that would present improved antibacterial drug release properties [87][88][89].…”