I just came across this explanation on Dr. Reinhorn’s practice page about why they are doing many more non-mesh hernia repairs, since 2015. When I see these types of commentaries I realize that I was unlucky enough to have my hernia at “peak mesh” times, in late 2014.
It’s good to see a rational reasonable decision made by a hernia repair surgeon, willing to leave the security of the mesh repair industry and refocus on the long-term welfare of the patient. I hope that more surgeons will be unafraid to leave the crowd and do what’s right, and that they will get support from their colleagues if they do. Maybe the tide is starting to turn.
“Why we offer non-mesh hernia surgery
In 2015, a patient asked us to perform the non-mesh hernia repair, also know as Shouldice hernia repair for an inguinal hernia. For many years, and even today, most surgical teaching suggests that mesh hernia surgery improves overall outcomes for the majority of patients. While we agree with this statement in general, there are patients and situations where a non-mesh repair is more appropriate.”
” The percentage of cases that we perform without mesh is increasing quickly. Currently, almost every week we perform several non-mesh hernia repair surgeries, accounting for more than 15% of our cases. “
Every surgeons’s practice is different. Eg, in some states in the USA, morbid obesity and smoking are highly prevalent. We know that that combination makes tissue-based hernia repairs a poor plan of care and laparoscopic surgery is usually a better choice. In my practice, my patients tend to be thinner and I see a lot of women. In such a population, I offer tissue repairs for inguinal hernias much more commonly than perhaps my colleagues who have a different practice.
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