To infinity and beyond: the promise of data-driven 3D printing of hernia mesh – a primer for surgeons

Purpose
Abdominal wall hernias account for a substantial operative caseload in general surgery globally. Optimal hernia care should be tailored to individual circumstances. To repair the three-dimensional (3D) abdominal wall, 3D-printed patient-specific implants may be superior to current mesh products. The aim was to review the current state of 3D printing technology in custom hernia mesh production, and its safety and efficacy for tailored hernia care.

Methods
A literature search within PubMed and Scopus databases were performed in March 2025, in accordance to PRISMA-ScR framework, using keyword combinations of printing, mesh, hernia, safety, efficacy and their derivatives. Full-text papers relevant to the study aim in all formats and languages were included, and risk of bias assessment was performed. The review was not eligible for registration with PROSPERO. Papers were grouped by general theme, and a narrative synthesis was performed.

Results
Thirty relevant papers were identified from 14,210 abstracts. Literature on 3D-printed hernia mesh was sparse, with majority of papers being preclinical. General focus of the literature was production, cellular toxicity, performance of adjuncts and short-term tolerance in small animals. Risk of bias was globally high to critical, due to underreporting of in vitro and in vivo methodology. Safety and clinical efficacy of 3D-printed mesh remained unknown. Numerous issues, including production, sterilisation and regulations, were identified and discussed.

Conclusion
3D-printed hernia mesh is the next step towards tailored hernia care, with significant potential not otherwise available with traditional mesh products. Substantial research is still required to clarify its safety and efficacy.