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No Mesh Hernia Repair

Recently, many patients are asking about no mesh repair of inguinal hernias. This question stems naturally from recent media attention given to class action lawsuits pertaining to certain mesh products since removed from the market. Social media is also rife with personal stories of mesh complications. Even though such stories and complications are rare, they are often very real and are worth discussing. There is a genuine concern about the long-term impact of foreign materials in our bodies.

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Understanding No Mesh Hernia Repairs

First and foremost, there’s no better person to discuss this with than an experienced Hernia Surgeon! It is important to understand the facts associated with mesh and non-mesh repairs and to have your questions and concerns addressed prior to moving forward with surgery.

Dr. Macdonald performs non-mesh hernia repairs if requested. He will be happy to discuss the details with you during your consultation. If you’d like to understand more about no mesh repair, read on. Or, simply discuss with Dr. Macdonald during your visit.

The History of No Mesh Hernia Repair

Understanding the history of mesh repair of hernias often helps patients make decisions about which operation suits them best.

Non-mesh hernia repair was the only option until the introduction of mesh in the 1960’s. During my own surgical training in the early 1990’s, most of my patients still had non-mesh repairs of inguinal hernias. Mesh simply hadn’t “taken off” yet. Over the ensuing years, however, mesh repairs did become popular, and within a decade, the vast majority of repairs were being performed with mesh. Mesh repair was an easy operation to teach and easier for most surgeons to perform than non-mesh repairs. It didn’t require as thorough an understanding of the complexity of groin muscle anatomy. Seemingly overnight, the art of surgical repair of the muscles involved in a groin hernia disappeared in favor of this “patch repair”. Now, just 25 years later, there’s some concern we may have abandoned a tried and true operation too quickly. But, we shouldn’t throw out the baby with the bathwater just yet…

The truth is, the vast majority of mesh repairs for inguinal hernias are extremely successful with a very low complication rate. Mesh repair has very likely reduced hernia recurrence rates worldwide, especially as it pertains to large hernias. Mesh has likely made it possible for all surgeons, in all parts of the world, regardless of training, to perform the same operation(mesh repair) with similar success rates, ultimately benefitting an enormous number of patients.

However, it is also likely true that this success has come at a cost, albeit rare. Mesh is a foreign body, and the body’s response to it may not be completely predictable.

Keep in mind, there is also an art to mesh hernia repair, as there was with non-mesh repairs. There are principles of the operation that must be strictly adhered to, and it remains the case that an experienced hernia surgeon can likely lower the complication of any type of repair.

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