Where to go for a no mesh or non-mesh hernia repair
Several centers across the world specialize in no mesh hernia surgery. Places like the Shouldice hospital just outside of Toronto, Canada have been doing mostly no mesh repairs for over 70 years. Their experience with no mesh hernia surgery, and training in high volume hernia care has rarely ever been reproduced. The Desarda center also offers a non mesh hernia repair option, though in our opinion, the Shoulidce technique is superior and has been tested and studied for decades. At Boston Hernia, our mission is to provide the same level of hernia care provided at places like Shouldice for patients who want mesh or non-mesh repair options.
Why we offer non-mesh hernia surgery
In 2015, a patient asked us to perform the non-mesh hernia repair, also know as Shouldice hernia repair for an inguinal hernia. For many years, and even today, most surgical teaching suggests that mesh hernia surgery improves overall outcomes for the majority of patients. While we agree with this statement in general, there are patients and situations where a non-mesh repair is more appropriate. For example, in thin patients with small umbilical or inguinal hernias, non-mesh repairs may equally effective in fixing the hernia while leaving minimal foreign material in the body. After this patient requested a Shouldice repair, we researched the technique and found that the outcomes for this non-mesh repair are excellent, especially when performed at a high volume. The Shouldice Hospital in Canada are the experts in this repair, as they developed the technique decades ago and still perform thousands a year even today. Over the last few years, we started offering non-mesh repair for certain patients with inguinal and umbilical hernias. The decision to proceed with no mesh repair is made on an individual basis.
Our experience with non-mesh hernia surgery
Since 2015, we have performed over 300 no mesh inguinal hernia repairs. Dr. Reinhorn has observed the non-mesh Shouldice repair technique by visiting the famous Shouldice Hospital in Toronto. Our thinking about non-mesh hernia surgery has evolved over the last 4 years. While 4 years ago, a single patient asked about the down side of mesh hernia surgery, today, the majority of patients ask about the risks and benefits of mesh use. The percentage of cases that we perform without mesh is increasing quickly. Currently, almost every week we perform several non-mesh hernia repair surgeries, accounting for more than 15% of our cases. While Dr. Reinhorn and Dr. Fullington understands and performs this technique here in Boston, the surgeons at the Shouldice hospital perform an average of 500 Shouldice surgeries every year, and thus will have more experience and likely better outcomes. Our philosophy, and the philosophy of doctors at the Shouldice Hospital, is that high volume hernia specialists can deliver better results.
About Dr. Reinhorn
About Dr. Reinhorn & Dr. Fullington
Dr. Michael Reinhorn is a specialist in inguinal hernia and umbilical hernia. Dr. Reinhorn started his practice as a full service general surgeon in 2001. In 2012 Dr. Reinhorn started to focus on the care of hernia and pilonidal patients. In 2020, Dr. Nora Fullington was recruited from her work as a general surgeon performing hundreds of laparoscopic hernia repairs to Boston Hernia. Together with their physician assistant team, they provide a focused practice designed to provide a superior clinical experience. The team performs approximately 700 hernia surgeries every year and offers a tailored approach for each patient from anesthesia type to consideration of mesh and no mesh repairs, laparoscopic and open surgery. We have published outcomes and continue to participate in hernia and surgery societies. Our research led to a reduction in opioid prescribing after hernia surgery. Currently, Dr. Reinhorn serves as the chair of the Opioid Reduction Task Force of the Americas Hernia Society Quality Collaborative.
For more detail about the surgery, read more on our non mesh repair page.