Don’t Believe Everything You Hear About Mesh

Mesh has been used in inguinal hernia repairs for over 70 years and has been considered the gold standard of care for the past 30 years.

The use of mesh in surgical procedures has developed a bad reputation over the years due to frequent commercials for lawyer services for patients who have undergone surgery with mesh placement. While the majority of these commercials have targeted patients who have had gynecologic procedures, the word “mesh” now comes with associated negative connotations and questions about its safety.

The traditional inguinal hernia repair (without mesh) involves closing the hole in the abdominal wall with sutures. This repair technique is associated with a substantial increase in risk of recurrence as well as post-operative pain. The use of mesh has significantly lowered the risk of inguinal hernia recurrence because it covers the defect in the abdominal wall rather than trying to suture it closed.

Chronic pain after hernia surgery has been linked to the use of mesh. While studies have shown the traditional mesh repair (plug and patch repair) to have a chronic pain incidence of up to 20%, this risk can be greatly reduced by the mesh placement in the advanced open pre-peritoneal inguinal hernia repair that I routinely perform.

Overall, the use of mesh in inguinal hernia repair is both safe and effective. Every several years, technological advancements allow for improved material characteristics that are better tolerated by patients. The type of mesh I use is made of polypropylene, which is resistant to infection. The mesh types I currently use are Ventrio™ ST patch for inguinal hernias and Ventralex™ patch for umbilical or ventral hernias.