I’m Worried About Mesh for My Hernia Repair, Is It Really Necessary?

November 22, 2019

Ever since the introduction of hernia mesh, the long-term complication rates – mostly in the form of hernia recurrence – have dropped dramatically. One of the biggest causal factors of hernia recurrence is a non-mesh repair. And while there are some newer, non-mesh techniques that have partially addressed the problem, recurrence is still a major issue.

The great benefit of hernia mesh is it provides a tensionless repair of the defect in the abdomen. There is no pulling of tissue and no risk that tissue tears from pressure due to a strong cough or strain, as with a non-mesh hernia repair.

This said, many patients still have legitimate concerns about permanent implantation of mesh in their abdomen. Further, advertisements and news stories about defective mesh seem more common in recent years. So, let’s dive in and see if mesh is truly a good option, or if it can be avoided altogether.

The Negative Press

First, let’s address the negative press surrounding hernia mesh. Over a decade ago, certain defective and counterfeit hernia meshes were recalled. These meshes were very difficult to detect because the counterfeit mesh was largely indistinguishable from the real stuff. This meant that many patients had improper mesh placed in their abdomens and some had complications as a result. Fortunately, this is no longer a concern and safeguards are in place to avoid this in the future.

Lighter, More Customized Mesh

Second, today’s mesh is lighter and more customized to the patient’s particular circumstance. The mesh of old was relatively heavy and created an extreme inflammation response. This increased the risk of certain complications including chronic pain after hernia repair. Further, meshes were not always chosen well, and the size and composition of mesh was not always appropriate for that particular patient. Our significant experience with hernia repair, and choosing a customized treatment plan for each patient, reduces the chance that patients do not receive the appropriate hernia mesh for their hernia repair.

Mesh Adhesion

Third, there have been amazing strides in improving the way that mesh adheres to abdominal tissue. Originally, mesh was attached with titanium tacks that remained in the abdomen permanently and could injure tissue or nerves, causing long-term pain. Titanium tacks evolved into absorbable tacks, but even these could potentially irritate nerves. Today, mesh is self-adhering and causes far less irritation.

Surgical Technique

Lastly, we perform most of our hernia repairs using the laparoscopic or minimally invasive approach. This means we access the surgical site using blunt dissection rather than sharp tools used for open surgery. This reduces the risk of cutting or irritating sensitive nerve bundles in the abdomen.

So, are there any downsides to using hernia mesh?

Hernia mesh is an implant, and therefore, we do not know exactly how the body will react to it until it has been placed and the patient has recovered. There is still a small risk that patients will experience chronic pain after surgery. However, many of the improvements in mesh-based hernia surgery listed above have mitigated those risks. Further, the surgeon’s experience plays a significant role in lowering the risk of any complications.

The bottom line, however, is that while hernia surgery is major surgery, it is also one of the most commonly performed general surgery procedures in the United States, with over 1 million hernias repaired every year, 800,000 of which are inguinal or groin hernias. Choosing experience goes a long way in ensuring that a mesh-based hernia repair is successful over the long-term. We encourage you to contact our office to schedule an appointment with one of our surgeons to discuss any concerns that you may have with mesh, and we look forward to helping you address your hernia.

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Advanced Surgical Associates is one of the first exclusively surgical groups practicing in Union County New Jersey. And that is just the first of many firsts for ASA. For over 40 years, we have pioneered breakthrough surgical patient care in North Jersey in both general and weight loss surgery. ASA also offers gastric bypass, gastric sleeve and gastric banding to those suffering from obesity in New Jersey.
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