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Mesh removal after hernia repair
Omyra mesh is an ePTFE mesh that is macroporous, ie, there are holes in it that are wide, allowing in-growth of tissue. There is little clinical evidence about this mesh and it is not a mesh with broad usage by surgeons, so I cannot scientifically assess it’s risks and benefits.
Proflor is also newly introduced in the US. There is more experience with this mesh outside the US and it has been positive.
My bias is that bulky mesh (such as Proflor) and shrinking mesh (such as ePTFE, similar to Omyra) have drawbacks and I prefer simpler mesh products.
Mesh removal is only indicated if there are mesh-related complications. Headaches and fatigue may be related to mesh reaction (inflammation) or mesh infection. I do not recommend mesh removal due to hernia recurrence. Mesh removal is a complex operation with multiple risks, and it should only be done by specialists. Laparoscopically placed mesh can be removed laparoscopically, by a skilled surgeon with prior experience. There are serious risks associated with this problem.
The Desarda technique is a non-mesh hernia repair technique promoted by Dr Desarda of India. It’s longterm results remain to be seen.