Hernia is a physiological condition that significantly impacts patients’ quality of life. Surgical treatment for hernias often involves the use of specialized meshes to support the abdominal wall. While this method is highly effective, it frequently leads to complications such as pain, infections, inflammation, adhesions, and even the need for revision surgeries. According to the Food and Drug Administration (FDA), hernia recurrence rates can reach up to 11%, surgical site infections occur in up to 21% of cases, and chronic pain incidence ranges from 0.3% to 68%. These statistics highlight the urgent need to improve mesh technologies to minimize such complications. The design and material composition of meshes are critical in reducing postoperative complications. Moreover, integrating drug-eluting properties into the meshes could address issues like infections and inflammation by enabling localized delivery of antibiotics and anti-inflammatory agents. Mesh design is equally important, with innovative structures like auxetic designs offering enhanced mechanical properties, flexibility, and tissue integration. These advanced designs can distribute stress more evenly, reduce fatigue, and improve performance in areas subjected to high pressures, such as during intense coughing, sneezing, or heavy lifting. Technological advancements, such as 3D printing, enable the precise fabrication of meshes with tailored designs and properties, providing new opportunities for innovation. By addressing these challenges, the development of next-generation mesh implants has the potential to reduce complications, improve patient outcomes, and significantly enhance quality of life for individuals undergoing hernia repair.

Pelvic organ prolapse (POP) occurs due to inadequate support of female pelvic organs and is often treated with synthetic implants. However, complications like infections, mesh shrinkage, and tissue erosion can arise due to biomechanical incompatibilities with native tissue. This study aimed to optimize the melt electrowriting process using medical-grade biodegradable Poly(ε-caprolactone) (PCL) with a pellet extruder to print meshes that mimic the mechanical properties of vaginal tissue. Square and diagonal mesh designs with filament diameters of 80 µm, 160 µm, and 240 µm were produced and evaluated through mechanical testing, comparing them to a commercial mesh and sheep vaginal tissue. The results showed that when comparing medical-grade with non-medical-grade square meshes, there was a 54% difference in the Secant modulus, with the non-medical-grade meshes falling short of matching the properties of vaginal tissue. The square-shaped medical-grade PCL mesh closely approximated vaginal tissue, showing only a 13.7% higher Secant modulus and a maximum stress of 0.29 MPa, indicating strong performance. Although the diagonal-shaped mesh exhibited a 14% stress difference, its larger Secant modulus discrepancy of 45% rendered it less suitable. In contrast, the commercial mesh was significantly stiffer, measuring 77.5% higher than vaginal tissue. The diagonal-shaped mesh may better match the stress–strain characteristics of vaginal tissue, but the square-shaped mesh offers stronger support due to its higher stress–strain curve. Overall, meshes printed with medical-grade PCL show superior performance compared to non-medical-grade meshes, suggesting that they are a promising avenue for future advancements in the field of POP repair.

Purpose: Develop biodegradable meshes as a novel solution to address issues associated with using synthetic meshes for POP repair.Design/methodology/approach: Computational models were created with variations in the pore geometry, pore size, filament thickness, and inclusion of filaments around specific mesh regions. Subsequently, one of the meshes was 3D printed to validate the results obtained from the simulations. Following this, a uniaxial tensile test was carried out on the vaginal tissue of a sow to compare with the simulations, to identify meshes that displayed behaviour akin to vaginal tissue. Finally, the most promising outcomes were compared with those of the uterosacral ligament and a commercially available mesh.Findings: Following a comprehensive analysis of the results, the mesh that most accurately replicates the behaviour of the vaginal tissue showcases a smaller pore diameter (1.50 mm), filaments in specific areas of the mesh, and variable filament thickness across the mesh. Nevertheless, upon comparing the outcomes with those of the uterosacral, the meshes do not exhibit similar behaviour to the ligament. Finally, the commercially available mesh does not represent the behaviour of both the vaginal tissue and the uterosacral ligament and in this sense may not be the best treatment option for POP repair.Originality/value: Their biocompatibility and biomechanical properties make them a potential solution to the disadvantages of synthetic meshes. Personalized/customized meshes could be part of the future of surgical POP repair.

Pelvic organ prolapse (POP) is a prevalent condition, affecting women all over the world, and is commonly treated through surgical interventions that present limitations such as recurrence or complications associated with synthetic meshes. In this study, biodegradable poly($ϵ$-caprolactone) (PCL) cog threads are proposed as a minimally invasive alternative for vaginal wall reinforcement. A custom cutting tool was developed to fabricate threads with varying barb angles (90°, 75°, 60°, and 45°), which were produced via Melt Electrowriting. Their mechanical behavior was assessed through uniaxial tensile tests and validated using finite element simulations. The results showed that barb orientation had minimal influence on tensile performance. In simulations of anterior vaginal wall deformation under cough pressure, all cog thread configurations significantly reduced displacement in the damaged tissue model, achieving values comparable to or even lower than those of healthy tissue. A ball burst simulation using an anatomically accurate model further demonstrated a 13% increase in reaction force with cog thread reinforcement. Despite fabrication limitations, this study supports the biomechanical potential of 3D-printed PCL cog threads for POP treatment, and lays the groundwork for future in vivo validation.

Pelvic organ prolapse (POP) limits people’s quality of life and is quite common in women, especially with advancing age. As cases increase, there is an urgent need for alternative treatments, especially for severe POP, where options remain limited. Surgical procedures involving synthetic meshes are associated with several complications, leading to the FDA (Food and Drug Administration) banning the commercialisation of these meshes to treat cases of transvaginal prolapse. Biodegradable meshes offer a potential solution to address the drawbacks associated with synthetic meshes, offering improved biocompatibility and biomechanical properties. This study developed computational models with variations in pore geometry, pore size, filament thickness and the inclusion of filaments in specific regions of the mesh. One of the meshes was then 3D printed to validate the simulation results. Subsequently, a uniaxial tensile test was performed on sow vaginal tissue to compare its mechanical behaviour with the simulations and identify meshes that closely mimic vaginal tissue behaviour. The mesh that most closely replicates vaginal tissue behaviour featured a smaller pore diameter (1.50 mm), filaments placed in specific areas, and variable filament thickness across the mesh. However, when compared to the uterosacral ligament, the meshes did not exhibit similar mechanical properties. Additionally, the commercially available mesh failed to replicate the behaviour of both vaginal tissue and the uterosacral ligament, suggesting it may not be the optimal option for POP repair. Biodegradable meshes, with their customisable properties, show great promise as future solutions for personalised and safer surgical treatment of POP.

Pelvic organ prolapse (POP) is a health condition that can significantly impact patients’ quality of life. Unfortunately, most available treatments present drawbacks such as high recurrence rates, risk of complications, poor tissue integration, and the need for reintervention. One promising alternative is the use of biodegradable implantable meshes, which can support the organs, guide tissue regeneration, and be fully absorbed without damaging the surrounding tissues. In this study, biodegradable polycaprolactone (PCL) meshes were fabricated using melt electrowritten (MEW), incorporating the antistatic agent Hostastat^® FA 38 (HT) to address these limitations. The goal was to produce microscaffolds with suitable biophysical properties, particularly more stable fiber deposition and reduced fiber diameter. Different HT concentrations (0.03, 0.06, and 0.1 wt%) were investigated to assess their influence on the fiber diameter and mechanical properties of the PCL meshes. Increasing HT concentration significantly reduced fiber diameter by 14–17%, 39–45%, and 65–66%, depending on mesh geometry (square or sinusoidal). At 0.06 wt%, PCL/HT meshes showed a 24.10% increase in tensile strength and a 55.59% increase in Young’s Modulus compared to pure PCL meshes of similar diameter. All formulations demonstrated cell viability >90%. Differential scanning calorimetry (DSC) revealed preserved thermal stability and changes in crystallinity with HT addition. These findings indicate that the antistatic agent yields promising results, enabling the production of thinner, more stable fibers with higher tensile strength and Young’s Modulus than PCL meshes, without adding cellular toxicity. Developing a thinner and more stable mesh that mimics vaginal tissue mechanics could offer an innovative solution for POP repair.