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. Discuss the potential benefits and risks of using mesh for hernia surgery with your surgeon before your operation.
Recurrence of the Hernia
Hernia recurrence is the most common complication of hernia operations, including those in which mesh is used. The causes include improper surgical technique, such as using a piece of mesh that is too small or cutting slits in the mesh; shrinkage of the mesh over time; 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.
Although mesh is specifically designed and processed to be implanted, the body recognizes it as a foreign substance. The reaction to the mesh and its inhibition of the natural defense mechanisms against germs increase the chance of infection of the mesh and surrounding tissues -- sometimes many months or even years after surgery. Some of these infections can be treated with antibiotics, but others require removal of the mesh and another solution for repairing the hernia.
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 usually must be removed for healing to take place.
There is always some discomfort after a surgical procedure. It usually diminishes fairly rapidly. Persistent moderate to severe pain at the surgical site -- especially if searing or similar to an electrical shock -- may be a sign of nerve entrapment by either the mesh, or the stiches or staples used to anchor it in place. A local anesthetic injected into the site may eliminate the pain. However, another surgery is sometimes necessary to release the nerve.
Warnings and Precautions
Contact your surgeon right away if you experience any symptoms that might indicate a complication related to your mesh hernia repair operation. Seek urgent healthcare if you develop any warning signs or symptoms that might signal a medical emergency, such as:
-- fever or chills
-- pain, redness, swelling or drainage from the incision
-- increasing or severe abdominal pain
-- painful new lump at the incision site
Reviewed and revised by: Tina M. St. John, M.D.