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Complications of Abdominal Hernia Mesh Repair

by
author image Dr. C. Richard Patterson
C. Richard Patterson is a retired surgeon and chief medical officer with special interest and experience in gastrointestinal, breast, cancer and trauma surgery. He is the author or co-author of 17 scientific publications, including textbook chapters.
Complications of Abdominal Hernia Mesh Repair
A woman at her doctor's office with severe stomach pain. . Photo Credit michaeljung/iStock/Getty Images

The development of implantable fabric meshes revolutionized hernia surgery. Your surgeon can choose to repair your hernia by pulling together your natural tissues or by using mesh to bridge the abnormal opening without creating any tension. The benefits of hernia meshes -- like those of all medical devices -- come with some risks, and you should discuss them with your surgeon before your operation. After surgery, contact your doctor immediately if you have any unexpected pain, redness, swelling or drainage from the incision.

Return of the Hernia

Hernia recurrence is the most common complication of hernia operations, including those in which mesh is used. The causes are improper surgical technique, shrinkage of the mesh, and movement or migration of the mesh. Second and subsequent hernia operations at the same site are more challenging and prone to failure than first attempts.

Infection

Although mesh is specifically designed and processed to be implanted, your body recognizes it as a foreign substance. The reaction to it and its inhibition of your natural defense mechanisms against germs increase the chance of infection of the mesh and surrounding tissues. Some infections can be treated with antibiotics but others require removal of the mesh and another solution for repairing the hernia.

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Intestinal and Skin Complications

When placed inside the abdominal cavity, mesh may become stuck to part of the bowel. There is usually no negative effect, but in some cases, the mesh can kink the intestine and cause a blockage, which requires surgical correction. It is also possible for mesh to erode through the wall of the intestine, leading to leakage of bowel contents. Placement of the mesh outside the abdominal cavity reduces the risk of intestinal complications but may result in erosion through skin. Exposed mesh is only rarely salvageable and most often must be removed for healing to take place.

Nerve Damage

There is always some discomfort after a surgical procedure. It usually diminishes fairly rapidly. Moderate to severe pain that persists -- especially if searing or electric -- may be a sign of nerve entrapment by either the mesh or the sutures or staples used to anchor it in place. A local anesthetic injected into the site may eliminate the pain. Another surgery is sometimes necessary to release the nerve.

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