Advancements in Hernia Repair Techniques and Products are Driving the Hernia Repair Devices Market

Hernia is a very common condition that occurs due to the projection of an internal organs or tissues through an abnormal opening in the surrounding protective tissue. Hernia can occur anywhere in the body but is most common in abdominal, groin, upper thigh and belly button regions, major factors leading to hernia includes the combination of pressure and excessive muscular strain, weakness or injury of the abdominal wall. Based on location, hernia is classified into several types such as inguinal, incisional, umbilical, hiatal, femoral and others. An Inguinal Hernia is the most common type of hernia and about 96% of all groin hernias are inguinal constituting largest proportion among the different types and are projected to keep the leading position. Incisional hernia is the second most common type of hernia that is caused due to the defect in the fibrous connective tissue (fascia) of the abdominal wall mainly because of an incompletely healed surgical wound or caused by the incision made in prior abdominal surgery. An umbilical hernia occurs when part of the fatty tissue or intestine protrudes through an umbilical opening in the abdominal muscles and is most common in infants and young children. A femoral hernia is a very rare type of hernia which occurs due to the protrusion of the tissue from the lower belly into the upper thigh near the groin.

Surgery is the gold standard treatment recommended for almost all types of hernia and the repair of hernia is known as hernioplasty or herniorrhaphy. Hernia repair can be performed through surgeries such as tension repair type, open-tension repair type, laparoscopic tension free repair type and robotic- assisted repair type. Open tension free repair is the most common type of procedure performed and laparoscopic surgeries are becoming popular globally as it offers better clinical outcomes than open surgical procedures.

Often in hernia repair surgeries, hernia repair devices such as fixation devices, meshes, balloon trocars and positioning systems are used. Fixation devices are used to allow insertion of instruments of different diameters while surgery and positioning systems are used to place the mesh at hernia site. Hernia repair mesh is a surgical implant that is used to deliver an additional support to weakened or damaged tissue. Hernia repair with surgical mesh is advantageous than the ‘open suture-only hernia repair’ as they improve clinical outcomes and lowers hernia recurrence rates. Among the meshes, the synthetic meshes are preferred more compared to biologic meshes due to their low-cost, easy availability and compatible nature with all types of the conventional and minimally-invasive surgical techniques. However, improved performance and increasing popularity of biologic mesh will have a major impact on synthetic meshes in the years to come.

Three significant changes have impacted the hernia repair techniques landscape, firstly the adoption of an open tension-free repair technique over the tension repair technique which involves the use of a flat sheet of mesh instead of sutures. Secondly, the transition to large pore meshes in the placement of small pore meshes and last, transition to laparoscopic technique over the open technique as it offers better clinical outcomes with low morbidity and recurrence rate. In addition, robotic-assisted surgical techniques for hernia repair is gaining popularity as it reduces the rate of hernia recurrence, lowers pain and shortens hospital stays compared to the other procedures, but its adoption is hindered as they are highly expensive.

Recent advancements in hernia repair devices include self-fixating (gripping) mesh and the articulating fixation devices in order to overcome the problems facing the laparoscopic procedure and also provide surgeons with greater access to weak spots within the abdominal wall and enable them to securely tack mesh into exact place. The fixation of mesh at complex sites is considered as the major concern in this market as the inappropriate fixation of mesh increases the chances of hernia recurrence and hence, to overcome this problem, the manufacturers are focusing on developing highly-flexible and self-fixation hernia meshes where the mesh can be fixed at the hernia site without using any staples or glue due to the presence of microgrip adherence technology. For instance, Medtronic`s Parietex Progrip self- fixating mesh is lightweight consisting of monofilament polyester and polylactic acid (PLA) is associated with shorter operative time compared to sutured mesh. Furthermore, drug-eluting hernia meshes are a novel advancement which is in development stage. These meshes elute anti-microbial drug such as sirolimus at the hernia site to reduce the infection rate. For instance, Ariste Medical, a Memphis (U.S.)-based start-up company, is working on a cost effective drug-eluting mesh for ventral hernia repair. The company is working with FDA to get the approval and is expecting to get regulator’s clearance by the first quarter of 2017. It is anticipated that, the usage of this mesh will increase due to its better biological activity and cost effectiveness. The University of Alberta is also developing a drug-eluting mesh where they are using sirolimus as a drug to reduce the infection rate.

According to IQ4I analysis, the Hernia repair devices global market is expected to grow at a CAGR of 3.5% to reach $3,351.1 million by 2022. The global hernia repair devices market is progressing at a moderate rate due to continued demand for tension-free hernia repair, worldwide rise in ageing and obese population, increasing adoption of minimally invasive surgical techniques such laparoscopic and robotic surgeries, demand for patient comfort and continuous advancements in hernia meshes and their fixation devices. Whereas factors such as high-cost associated with minimally invasive hernia repair procedures, post-operative complications, risk of infection and complications associated with hernia repair mesh materials are restraining the market growth. Geographically, developed regions of North America followed by Europe dominates in revenues, however, Asia-Pacific region is propelling with fast growth due to the increased patient pool of geriatric as well as bariatric, and increased government investments in healthcare infrastructure.

Some of the major players in global hernia repair devices market are C. R. Bard, Inc., (U.S.), Medtronic, Inc, (Ireland), Atrium medical (Getinge) (Sweden), Aspide medical (France), Cook medical (U.S.), J&J (Ethicon) (U.S.), B. Braun Melsungen AG (Germany), Acelity L.P. Inc. (U.S.), W. L. Gore & Associates, Inc. (U.S.), Insightra Medical Inc. (U.S.). Some of the emerging players are players are A.M.I. GmbH (Austria), Angiologica BM Srl (Italy), Cousin Biotech (France), DSM Biomedical B.V., (Netherlands), Integra Lifesciences (U.S.), Assut Europe S.p.A. (Italy), etc.


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