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Tissue repair was taught before the 1990’s. Mesh repair started to be applied in the 1980’s. Once we saw that patients were having less pain with this procedure, had less recurrences, and it could even be done as an outpatient surgery, tissue repair fell out of favor. It was used only in situations where mesh was contraindicated (e.g., strangulation, infection).
The current wave of mesh-related complications and pain was not notable until this century. It’s debatable why we are seeing it.
There is for sure a need for more education and practice with the different tissue repairs. I agree with you. I offer it and a handful of surgeons older than me. The younger generation of surgeons are not adequately trained in it.