Hernia is a very common occurring health issue. The condition occurs when an organ or tissue pushes through a weakened or opened spot in a muscle or connective tissue in the abdominal region. The hernia causes a bulge in the groin, a sharp burning sensation and discomfort as the organ protrudes through the muscle wall.
The presence of an opening or a weakening spot can commonly occur in patients and does not necessarily need immediate medical attention. Over time, the organs begin to actively push through the weakening calling for medical intervention. In severe cases of hernia, the intestine could get engulfed in the hernia. Such cases need immediate surgery.
Hernias are of different types and so are their surgical procedures and treatment methods that have developed in recent times. The use of prosthetic mesh for hernia repair is one of them. These prosthetic meshes have been used for over 50 years in the medical field. It was believed to be the most reliable approach for the repair.
However, with the advent of modern medicine, the safety of prosthetic meshes is being questioned and rethought
Is prosthetic mesh safe?
Although the prosthetic mesh has been a gold standard for hernia repair, it is found to be associated with certain complications.
Mesh used for repair are sterile, woven material made from a synthetic plastic-like material, such as polypropylene. Though a sterile entity, it still is a foreign material that is introduced into the body. So there are possibilities of causing infection if the mesh is exposed to contamination. There are also chances of the mesh causing obstruction for bowel movements and scarring adjacent tissues. There are instances of the formation of adhesions. However, the adhesions occur in all patients who have undergone surgery in the abdomen. Hence mesh cannot be regarded as the sole cause for adhesion.
Regardless, as medical practitioners, the pros and cons of surgical procedures are precisely gauged.
Benefits from using prosthetic mesh
Before the applications of prosthetic mesh, many years ago, the hernia repair was done by performing a simple suture and then closing the hernia. But for certain kinds of hernia, the success rate of this approach was low with the hernia recurring at a later stage.
But the use of mesh revolutionized the repair of the hernia. The major benefit of the application of mesh is avoiding the recurrence of the hernia. The prosthetic meshes are plugged and patched in the weakened area to thereby strengthen the opening.
Complications from using prosthetic mesh
Majority of the reliable sources of scientific pieces of literature and peer-reviewed articles have suggested that the major complication from a surgical hernia repair, be it with mesh or without, are burning pain, infection, tissue scarring, adhesions of tissues, vessels or organs, obstruction of large or small intestines, bulging at the area of surgery due to fluid build-up, occurrence of perforation in adjacent tissues or organs.
Apart from the above listed adverse occurrence following a surgical hernia repair, the complications that are specific to hernia repair using a prosthetic mesh are the displacement of the mesh (mesh migration) and the shrinking of the mesh (mesh contraction).
The numerous cases of hernia repair complications that have been reported to the FDA are found to be affiliated to the recalled mesh products and not from the approach itself. These recalled mesh products are no longer being used in the surgeries as per the directions of the FDA. Some of the common complications include infection, obstruction, severe pain and recurrence. It has been reported that the main cause for the bowel perforations and obstruction are the recalled mesh products.
Are hernia treated without the application of a prosthetic mesh?
The application of the prosthetic mesh is relative to the type of hernia that needs to be repaired. While the mesh is not always necessary, it is often recommended. Groin hernia has been treated successfully without the use of mesh. Mild cases of hernia near the navel have been treated by simply suturing the hernia laparoscopically with promising success rate and no recurrence.