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Differences in the ProGrip Meshes?
Anyone know what the differences between these three types of mesh are in the context of inguinal hernia repair?
ProGrip Laparoscopic Self-Fixating Mesh
ProGrip Self-Gripping Polyester Mesh
Parietex ProGrip Self-Fixating Mesh
I assume some can be used via open and some can only be used via laparoscopic? Which ones would have have more or less inflammation/risk for chronic pain?
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10 Replies
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Here’s a randomized trial they did on hippos comparing progrip vs sutures. Surgery time was nine minutes faster with the progrip,
Frankly, hippos would be my last choice to test mesh on. ¯\_(?)_/¯
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I looked this up and the meta analyses that I read all came to the conclusion that the pain and recurrence levels were about the same. The advantage for progrip was in the quicker operating time. I think we’re talking a few minutes there,though. Here’s one link:
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Does anyone also know if these ProGrip meshes are better than mesh requiring sutures? I would imagine the ProGrip ones are marketing a self-fixating so without the use of tacks, sutures, or staples.
How do these self-gripping meshes compare with pain level and complication risks with regards to traditional sutures/tacks/staples?
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Definitely confusing
The Progrip mesh for open inguinals hernia is specifically designed for an onlay Lichtenstein patch technique repair. It was originally polyester. As the company is growing, they are carrying more polypropylene based meshes too, as a means of securing hospital contracts from its competitors.
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I hope this is my last post here, but I keep finding more. Medtronic’s product portfolio catalog contains all of their mesh products and uses the proper words in the descriptions. Apparently, for whatever reason, the Progrip polypropylene mesh is not specified for laparoscopic procedures. Maybe it’s not flexible enough for the canula.??? Why would it be okay for open but not for laparoscopic? Either of the Progrips, polyester or polypropylene, is specified for open repair.
Anyway, it’s interesting reading. Strange also, that they call out “open inguinal mesh” but not “laparoscopic inguinal mesh”.
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I almost hate to pile on but I think that it is important to understand how these points of confusion happen. Medtronic has, apparently, reviewed what they got when they purchased Covidien and decided to leverage the “Progrip” name and concept. You can see that they even contradict some of the previous selling points of polyester, that were made in the Covidien video, that promoted polyester over polypropylene. Whatever makes the product look good.
Here is the broader view from Medtronic.
“Whether you prefer polyester or polypropylene, ProGrip™ mesh is now available in the material you require for your patients.”
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Here is one of the original Covidien videos where they describe a similar name, ProGrip™ Laparoscopic Self Fixating Mesh, as a polyester mesh substrate. It’s at 2:15 in the video.
You can see that the Progrip name is being used on different substrates. So, unless a person checks the documentation they might not know what they are working with because the supplier has changed the product but kept the name. Not all Progrip is the same.
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SN’s post actually left the polyester or polypropylene question open-ended. For whatever reason Medtronic puts the word polyester in to the name of at least one of their Progrip products on their web site but leaves the other undefined.
The Medtronic Youtube page is more specific. They are using the self-fixation material, aka Progrip, on both polypropylene and polyester mesh substrates. Unless somebody made a mistake in their video production.
My background contains some materials science so these types of questions interest me. For the record, there are many variations within the classifications of polypropylene and polyester. The word “polyester” is especially undefined. Even the polylactic acid polymer is, literally, a “polyester”. A polymer of ester bonds. The manufacturing process used to make the fibers also has a significant impact on properties.
The medical device makers know all of this. But the tradenames allow them to market the product more effectively.
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Progrip refers to the Velcro like technology of the mesh.
Progrip lap self fixating mesh is typically used for lap inguinal hernias. It comes in rectangular or anatomical shapes. The rectangle one can also be used for any appropriate sized ventral/incisional hernias as long as it is not against bowel.
Parietex Progrip is specifically meant for open inguinal hernia repair in Lichtenstein fashion.
All above are polyester.
Our paper on why we remove mesh quantified the different mesh types and polyester meshes seemed to be less of an issue than polypropylene. However, less polyester based mesh was in the market then as well.
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It looks like the word “Progrip” is being used to describe any mesh that has the polylactic acid (PLA) absorbable component. That is approximately 40% of the weight of the material. Apparently, Progrip is applied to both polyester and polypropylene meshes.
The word “Parietex” appears to be a trademark that was originally used for polyester meshes. But now appears to be used for other materials also.
There used to be more information readily available through the internet but Medtronic seems to have removed much of it and now asks people to contact them for information. It wouldn’t be a surprise if this is due to the lawsuits. If you search Progrip and/or Parietex on the internet a bunch of law firm results show up along with Medtronic web sites. There is some poor information on those sites about the difference between polyester and polypropylene.
Sorry, that probably doesn’t help much. The basic materials are essentially the same, of those three. The form is different, and I think that one or two of them might be polypropylene.
I don’t think that you will be able to find any studies that will clearly tell you which of these materials has less risk for chronic pain. Good luck.
https://www.medtronic.com/covidien/en-us/products/hernia-repair/mesh-products.html
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