Traditional mesh surgery includes many different repairs including plug and patch repair, Lichtenstein repair, and Prolene Hernia System. Traditional mesh surgery is the most commonly performed hernia repair in the United States. These traditional repairs are open repairs that have been proven over many years to be effective. These repairs are easy to learn and are the most common repairs taught in residency programs. The recurrence rate is low and recovery time is about 6 weeks to full physical activity. The drawback of traditional mesh surgery is the placement of mesh within the abdominal wall. This anterior mesh placement can result in an incidence of chronic pain in up to 15% of patients. This chronic pain is often related to nerve injury or mesh contraction.
While traditional hernia surgery remains the most common type of hernia repair, we very rarely offer this type of repair to our patients. In our practice, we now remove many “plugs” as they often contribute to chronic pain and they can interfere with a solid preperitoneal repair. In patients with chronic pain after hernia surgery, we will occasionally remove anterior mesh as well as affected nerves. The decision to proceed with mesh removal or nerve removal should be made with your hernia surgeon.