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Order of operations (So to speak)
What would cause an open non-mesh surgery to fail years later. (Shouldice , Desarda, et alia?). I know of several people who have had colon surgery, with an incision below the belly button of at least two or three inches. Yet the open incision once sowed up after the colon surgery never splits or tears back open? What is so fragile about the flesh in the Inguinal hernia area which would cause it to fail, or tear back open? This is not a rhetorical question, I am just trying to understand why a non open repair might fail?
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1 Reply
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It is incorrect to feel that incisional hernias never open. The overall risk of incisional hernia is 11% and that number can vary based on the specifics of the operation and the patient.
The inguinal area is more prone to herniation because of the collagen in the area being abnormal. Also, we are upright beings, so there is more pressure in the pelvis. Lastly, male pelvis is narrow, so from a physics standpoint there are more forces into the inguinal canal than in females.
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