The quick and easy answer is: not often.
The standard of care in the US for more than 30 years has been to repair hernias with mesh. If mesh was dangerous, it would not be used in almost 99% of hernia repairs. Every year, many patients have complications of any surgery, including hernia surgery. Some of these complications can be related to the use of mesh. Because there are many ways to fix hernias, the complication rate is quite variable, depending on the technique used. The biggest problem after hernia surgery is chronic pain. While mesh can contribute to this, hernia repair options that do not include the use of mesh, often are associated with chronic pain as well. As more and more outcome data becomes available, we are learning that not all hernia repairs are created equal. Placement of the mesh in a posterior position (on the inside of the hernia) as is accomplished in the open preperitoneal repair and laparoscopic repair is associated with a lower risk of chronic pain, and very few mesh complications. For thin patients, a non-mesh repair may be a good alternative. We have been offering the Shouldice non-mesh hernia repair for our patients since 2015 and perform this procedure almost every week.
January 2024: Coming soon – a long explanation on how we use data to show that mesh is not only safe but enhances the quality of life in patients who undergo inguinal hernia repair in high-volume centers.
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.