Long term outcome and quality of life after open incisional hernia repair - light versus heavy weight meshes

12 patients who underwent midline open incisional hernia repair with a HW-PP mesh (Prolene？ 109 g/m2 pore size 1.6 mm) between January 1996 and December 1997 were compared with 12 consecutive patients who underwent the same procedure with a LW-PP mesh (Vypro？ 54 g/m2, pore size 4-5 mm) from January 1998. The standard technique was the sublay mesh-plasty with the retromuscular positioning of the mesh. The two groups were equal in BMI, age, gender and hernia size. Patients were routinely seen back in the clinic.In the long term run (mean follow up 112 ± 22 months) patients of the HW mesh group revealed no significant difference in the SF-36 Health Survey domains compared to the LW group (mean follow up 75 ± 16 months).In this study the health related quality of life based on the SF 36 survey after open incisional hernia repair with light or heavy weight meshes is not related to the mesh type in the long term follow up.Hernia repair is one of the most common surgical operations with more than 50.000 incisional hernia repaired every year in Germany. Patient seek surgical repair because of physical discomfort and aesthetic reasons. Both impair their quality of life. Unfortunately some patients complain of abdominal discomfort also after the operation. Despite the surgical technique one possible factor is the type of mesh used. Polypropylene (PP) is the most widely used mesh material for hernia repair. PP meshes show a high stretch and tensile strength, five times higher than the maximal physiologic stress. The extent of the scar tissue induced by the mesh depends on the amount and structure of the incorporated material and is responsible for the abdominal wall compliance [1,2]. In 20% of the cases heavy weight (HW) and small pore size PP meshes caused a reduction of the abdominal wall mobility ("stiff abdomen")[3,4]. This complication was associated with chronic abdominal pain. As a consequence macropore light weight (LW) PP meshes strong enough to resist maximal physiol