Can Hernia Be Repaired Without Mesh

Dr. Andrew T. Bates

Hernias are a common health trouble, with more than 1 million hernia repairs performed each twelvemonth in the United States. Approximately 800,000 are done to fix hernias in the groin, and the remainder are for other types of hernias in the abdomen.

A hernia occurs when at that place is a weakness, or opening, in the muscle and connective tissue that surround the belly surface area. Patients may experience a slight bulge, discomfort, or pressure as organs push out through this weakness.

Nevertheless, many patients may take this opening/weakness even if organs aren't actively pushing through. Over time, this bulge or surface area of weakness tin can abound in size. Occasionally, intestine can become trapped in the hernia, which requires emergency medical attention.

Not but are in that location different kinds of hernias, different methods and surgical approaches are currently used to repair them. Today, a "mesh" production is normally used in hernia repairs.

Hernia mesh has been around for over l years, and earlier versions of it have long been regarded as the "gold standard" to utilise in repairs. However, some websites today make claims that mesh is unsafe, and that repairing hernias without mesh is better.

Here, Andrew T. Bates, Dr., director of the Stony Brook Comprehensive Hernia Center, answers frequently asked questions about hernias and the mesh used to repair them.

Q: Must a hernia be repaired?

A: All hernias have the potential for trapping abdominal contents, such every bit intestine, which is why we typically recommend repair in patients who are adequate surgical candidates.

Not all hernias, though, are the same, and so we oftentimes employ a different arroyo based on the location of the hernia, such every bit groin or intestinal wall.

In the instance of groin (inguinal) hernias, surgeons in the recent past advocated for "watchful waiting" for hernias that were non particularly bothersome.

However, based on newer research, we now know that a big percentage of these hernias volition later become bothersome and crave repair, possibly emergent, and therefore nosotros advocate for repair.

Q: Does hernia repair require mesh?

A: Not necessarily, but usually. In the right patients, some groin hernias tin be repaired without mesh and withal have acceptable success rates. Additionally, some minor hernias at the belly button can exist repaired with suture lone. Most repairs, though, do utilise prosthetic mesh to achieve a successful repair.

When patient care is seamless as washed here, outcomes improve.

Q: What exactly is mesh?

A: The term "mesh" is used to draw a flat canvass of prosthetic textile that is used to cover, or "patch," a hernia.

Q: Are there dissimilar kinds of mesh? How are they different?

A: There is a sizable industry devoted to a large array of hernia meshes. Some are made of various plastics; some are fabricated of biologic materials. Some are permanent and some are designed to dethrone over time.

The most mutual type of mesh is made of a plastic material and closely resembles a window screen in appearance. Some meshes are also made with protective coatings that allow them to be placed in the abdomen near the intestinal organs.

Q: What are the advantages of using mesh in hernia repair?

A: Decades ago, hernia repairs were performed by simply suturing the hernia closed. For some types of hernias, this repair resulted in 25-50% of hernias afterwards returning. Mesh changed that. Past using mesh, the run a risk of hernia recurrence dropped to the low unmarried-digits.

Q: Does mesh crusade problems in hernia repair?

A: In well-nigh cases, using mesh is the adequate standard of care. However, at that place can certainly be complications related to the mesh.

Q: What specific problems are associated with mesh?

A: Mesh is a strange trunk that your body incorporates to help strengthen the repair. However, being a foreign body, it can also go infected if information technology becomes contaminated either at the time of surgery or later. This may require mesh removal.

Mesh placed inside the abdomen tin can as well lead to scar tissue, or adhesion, formation that can predispose patients to bowel obstacle down the route.

Yet, all patients who have had surgery in the abdomen as well form these adhesions, so this is non a problem specific to the mesh itself.

Virtually brands and models of mesh have excellent safety profiles.

Q: Why are mesh companies being sued now?

A: There are many sizes and shapes of mesh, all with different strengths and flexibility. Some lightweight meshes were removed from the marketplace after cases of breakage were reported, merely most brands and models of mesh have excellent safety profiles.

There were also other surgeries that used mesh, such as vaginal sling surgery, which regrettably had a high complication charge per unit just is a completely dissimilar surgery altogether. In the vast majority of cases, complications are the result of surgical technique and not the mesh used.

Q: When mesh is required, is traditional open surgery or minimally invasive laparoscopic surgery better?

A: This is incommunicable to reply because every patient is different and every hernia is different. What is right for one patient may not be best for another.

For this reason, an individualized approach is fundamental. What our inquiry has shown is that surgeon feel with a particular technique is the nearly important factor, whether it is laparoscopic or open.

Q: What practice the latest major scientific studies say well-nigh mesh? Is there a consensus?

A: In about hernias, mesh is the standard of intendance. This is what the scientific discipline clearly indicates, and information technology is backed up by well-designed clinical trials as well as retrospective studies.

Q: What is the reward of having a hernia repair with mesh done at Stony Brook?

A: The advantage is two-fold: academic and comprehensive. By having your repair at an academic establishment similar Stony Brook Medicine, you lot take advantage of a surgery faculty that utilizes the newest techniques and, in many cases, is driving the field forward.

Our surgeons present their work at national societies, and have published countless articles about their research projects in respected surgical journals. As bookish surgeons, we are committed to making surgery better.

"Comprehensive" ways that all of your needs are addressed under one roof, delivered past a collaborative team dedicated to fantabulous patient outcomes.

Our center includes open, laparoscopic, and robotic surgery specialists. Nosotros work closely with plastic surgeons for those patients that may require circuitous repair.

We have likewise integrated pain management specialists into our treatment protocols for those patients suffering from debilitating hernia-related pain. When patient care is seamless as done here at Stony Brook, outcomes improve.

The Stony Brook Comprehensive Hernia Center — distinguished past Stony Brook Medicine'south multidisciplinary approach to patient intendance — offers a wide range of options to diagnose and care for most types of hernias. Our experienced hernia experts work together as a team to design the best treatment plan possible so patients tin can become back quickly to their normal lives and daily activities. Patients can run across our hernia specialists at our Suffolk County offices in Centereach, East Setauket, Smithtown, and Commack.

Source: https://www.stonybrookmedicine.edu/patientcare/surgery/patient-care/clinical/general-surgery/patient-education/faqs-about-mesh-in-hernia-repairs

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