Reply To: To Mesh or not to Mesh
First, take the surgery as soon as possible.
The incisional hernia should be operated as early as possible.
The larger the hole, the harder the operation and the greater the risk of postoperative recurrence.
Incisional hernia has been reported to be highly recurrent compared to other hernias such as inguinal hernia.
Second, use reinforcement material, but a Goretex cloth if possible.
I am a strong advocate of no mesh inguinal tissue repair. However, my principle of incisional hernia is to use mesh/material.
As mentioned above, it is a highly recurrent hernia, its opening is usually much larger than inguinal hernia, and the border of hernia opening is firmly fibrous and resistant to be put together.
However, I use Goretex cloth instead of polypropylene mesh to prevent the bowel from sticking to it. (in many cases, peritoneum/barrier is torn and absent and the bowel could contact directly to mesh/membrane. Goretex is resistant to sticking of bowel)
Third, be sure to close the hernia opening itself.
Some doctors do not close the hernia opening by direct suture, but merely cover the hole with a mesh.
However, this would cause a lot of recurrence.
Therefore, the hernia opening must be tightly sealed.
In addition to this, it is better to put mesh deeply inside the tissue closure layer.