General Surgery Blogs

Dr. Steven Williams in Boise, Idaho

07Feb

Do I Have to Have Mesh Placed to Fix my Hernia?

Dr. Steve Williams | Hernia Repair | | View Counts (1923) |Return|

This is a great question, and like most great questions, it is because the answer is complicated.

First of all, not all hernias require mesh to be repaired and resolved. However, mesh is an invaluable tool which has allowed surgeons to be able to reliably repair hernias which in the past were not possible to repair. Not all hernias are the same and not all meshes are the same. Mesh is a tool and a good surgeon will understand the limitations of the mesh, which mesh is best for which type of hernia, what complications the mesh product could possibly bring into the equation for the patient, and what the mesh could lend to the repair to decrease the risk of recurrence and provide optimal healing for the patient. For some hernias, such as small umbilical hernias, some hiatal hernias, and inguinal, or groin, hernias in children, mesh can be avoided with acceptable risks of recurrence.

For most adult inguinal hernias and many ventral (abdominal wall) hernias, mesh provides a safe and reliable way to buttress the repair and greatly decrease the risk that the patient will develop a recurrent hernia. Many horrible, large complicated abdominal wall hernias started out with a small hernia which recurred after repair and then another attempt led to another recurrence. As you can imagine, a patient’s best bet is to have the hernia fixed once and for all with the first surgery. When hernia mesh for inguinal hernias became available around 1990, mesh was originally reserved for those patients who underwent inguinal hernia surgery and then developed a recurrence of their hernia and needed a second (or third!) surgery. It soon became apparent that mesh decreased the recurrence risk and became first line therapy for those undergoing their original inguinal hernia repair. Tissue only (no mesh) repairs for inguinal hernias usually cause more discomfort during healing and have increased risks of recurrence compared to mesh repairs. This is the reason mesh inguinal hernia repair is the standard of care.

I perform non mesh inguinal hernia repairs, but I caution those patients that the tissue repair will have a higher risk of recurrence. Without a doubt, if I am personally undergoing inguinal hernia repair, I will have mesh placed. However, I personally did undergo repair of a small umbilical hernia and had a suture only, no mesh repair, which has lasted about 10 years now with no issues. Again, not all hernias are the same and not all meshes are the same.

Listen to your surgeon, ask all of the questions you need to ask, and if you still are not comfortable, obtain a second surgical opinion.

If you have more questions, be sure to check out our Hernia FAQ page here.

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Practicing General Surgery in the Boise area since 2002