4DMesh

4DMesh is a partially resorbable monofilament implant composed of PP and PLLA, with approximately 75% of the initial mass corresponding to resorbable PLLA and 25% to permanent PP. This material concept ensures the necessary mechanical stability in the early phase while reducing the material load in the long term. The macro-porosity and transparency of the knit facilitate anatomical orientation and tissue integration. The hydrophilicity of the PLLA component contributes to a gentle holding effect on the wall, without aggressive fixation systems.

4DMesh is designed for parietal reinforcement in inguinal and femoral hernias and covers a wide range of techniques: open Lichtenstein-type repair with right/left preformed meshes, TAPP and TEP laparoscopic procedures with flat or anatomical implants, and plug & patch approaches in combination with appropriate 4D components. 4DMesh thus offers a flexible solution for common and more complex situations in inguinal hernia surgery.

4DMesh is implanted in the extraperitoneal position and deploys easily, in both open and laparoscopic surgery, to conform to the abdominal wall. Flat variants can be cut to adapt the mesh size to the defect and anatomy. The implant is compatible with all common fixation methods (sutures, staples/clips, glue); clinical data show that 4DMesh can, in certain laparoscopic contexts, be used with reduced fixation or even without additional mechanical fixation, depending on defect size, technique, and surgical team experience.

For 4DMesh, several clinical studies and registry analyses are available, particularly in TEP and TAPP. Compared to standard PP implants, significantly shorter operative times, less postoperative pain, faster return to work, lower seroma/hematoma rates, and very low recurrence rates are observed. Registry data (notably Club Hernie) also show a higher proportion of asymptomatic patients and less moderate to severe pain at distance compared to competing implants, with comparable and low recurrence and infection rates.[1–4]
[1] Agca B et al. North Clin Istanb. 2019;6(4):388‑392.
[2] Kabaoglu B et al. Sisli Etfal Hastan Tip Bul. 2024;58(3):276‑283.
[3] Lund H et al. Surg Endosc. 2025;39(4):2464‑2470.
[4] Club Hernie Registry – comparative studies 2023 (4DMesh® anatomical, laparoscopic technique) and 2024 (4DMesh® vs competing meshes, Lichtenstein technique).

Material: composite monofilament implant made of poly-L-lactic acid (PLLA) and polypropylene (PP), approx. 75% PLLA (resorbable) / 25% PP (permanent)

• Weight: approx. 30 ± 10 g/m² after resorption
• Design: transparent macro-porous mesh, soft and highly flexible
• Application: parietal reinforcement for the treatment of inguinal and femoral hernias; extraperitoneal implantation in open Lichtenstein-type surgery and TAPP/TEP laparoscopy
• Shapes (examples): right/left preformed Lichtenstein implants (with/without flap), flat implants, TAPP/TEP anatomical implants, square/rectangular implants.