The use of mesh has revolutionized hernia repair over the last several decades. By using mesh we can drastically reduce the chance of the hernia coming back (recurrence). That being said, we are open and understanding about the criticism that mesh has received and now offer a variety of options including no mesh repair, biologic reinforced repair and traditional mesh repair. Ultimately this will be a choice made between your surgeon and you. We recommend you use the SCAFFOLD Guide to further explore your options.
Hernia repairs have traditionally had a high chance of failing. Since the 1980s there has been a steady increase in the use of mesh to reinforce hernia repairs which has dramatically decreased the chance of the hernia coming back. The use of mesh can also decrease the possibility of pain after surgery. Currently, well over 90% of hernia repairs are performed using mesh reinforcement.
150 Types of Hernia Mesh
Available on the market include: synthetic (plastic), absorbable synthetic, biologic (animal derived) and hybrids which are made of a combination of synthetic and biologic materials.
Like most things in life an individualized approach is best when deciding which type of mesh reinforcement to use for your hernia repair. Traditional, synthetic (plastic) mesh has an excellent track record and is used in the vast majority of hernia repairs across the globe. Many patients are attracted to newer technologies such as reinforced biologic mesh. We recommend exploring this interactive guide developed by abouthernia.com to learn more about your options.
Is it all true?
It is difficult to search the web about hernias without coming across a flood of advertisements questioning mesh safety.
It has been greatly blown out of proportion, but yes, like any surgical product mesh can cause complications. Many of the meshes that were more likely to cause complications have been recalled by the FDA. However, any mesh has the potential to cause pain, infection, scar tissue formation which can lead to bowel blockage, abnormal connections with the bowel (fistula) and lead to return of the hernia (recurrence) due to mesh migration or shrinkage (contraction). All of these complications are very rare and, in general, the benefit of using mesh reinforcement far outweighs the risk.
Yes, in select situations a no mesh hernia repair is safe, feasible and effective. However, we often find that after a thorough discussion with their surgeon patients select NOT to have a no mesh repair. In most instances no mesh hernia repairs are performed using open surgical techniques which lead to increased post-operative pain and longer recovery. The chance of the hernia coming back is also drastically increased in a no mesh repair. After discussion, we find that the fear patients have isn’t actually of mesh, it is of having a permanent foreign body inside of them. These patients often end up selecting a biologic or reinforced biologic mesh which will be slowly remodeled into their own body’s natural tissues. This allows for the “best of both worlds”. Ultimately decreasing (or eliminating) the amount of foreign body left from the repair while maintaining strength to limit the chance of the hernia coming back. We encourage you to use the resources throughout this website and to speak further with your surgeon to learn more about this very important decision.