When the suture repair is done correctly, there is minimal tension.
On the other hand, remember that mesh will shrink 50%. So in 6 months a mesh repair becomes a tension repair.
Bill Brown MD
One could also argue when a mesh repair is done correctly with a right sizing of a mesh by a skilled hernia specialist who is trained in a tension free mesh repair it can remain tension free or be more tension free than traditional shouldice …
It is proven that mesh does shrink over time but I think it shrinking to a point of it being a tension repair in 6 month would be in a case of a poorly performed mesh repair.
The real question is whether do you want to take the chance of a potential complication with mesh, which is far more complicated than chronic pain from a poorly performed tissue repair.
– tissue repair is also on more tension than before the repair. You are closing a hole between two potentially weak tissues. There are ways to reduce the tension and muscle does stretch.
– mesh shrinks 10-25%. ePTFE mesh shrinks 40% and most surgeons don’t use that die inguinal hernias. Yes, if placed loose to allow for that shrinkage, a mesh repair can be without tension with excellent results.
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