Why do hernia surgeons still use mesh?

[Katherine]

I am just wondering – why do hernia surgeons still use mesh with all the complications that arise from it? Are there newer mesh materials that do not have any complications? I saw several surgeons a few years back in an attempt to find a tissue repair surgeon, but could find none locally. Now I’m in the same position again since my hernia has worsened, but afraid I’m faced with the same issue. Do I just “give in” to mesh? And at what point do you get it repaired? It sticks out quite a bit and when I squat down, sometimes I will feel the popping in and out – but I wouldn’t really say it hurts really bad yet – just a little bothersome. Any thoughts would be much appreciated!!!

[drtowfigh]

There are multiple different ways to treat hernias. Mesh-based is one of them. And there are a multitude of mesh options and mesh repair options.

It is best to have your hernia repair tailored to your needs. A true hernia specialist should be able to offer you the risks and benefits of a range of repair options. Some hernias cannot be repaired without mesh.

There are risks with all operations. This includes complications due to mesh or complications after non-mesh repairs. We have many examples of both on this forum.

In general, most hernias should be repaired when they are symptomatic.

[Katherine]

Thank you, Dr. Towfigh. This may be a stupid question – but in your opinion, what defines symptomatic? Exhibiting any symptoms at all, or to the degree that it interferes with daily activities, etc.? I guess I would consider mine mildly symptomatic, but other than the bulge, quite often I don’t even notice it’s there unless I do a lot of squatting down or try to do core exercises (which makes it pop out more and then become more tender). Would a hernia surgeon not know whether to use mesh or not until they are actually doing the surgery or could a good surgeon be able to tell before they actually visualize the tear?

[drtowfigh]

Symptomatic implies any symptom. It could be a mild twinge or debilitating pain. Minimally symptomatic implies your symptoms are mild and do not interfere in your daily activities.

It’s standard to have a discussion prior to surgery about the planned surgical technique.

[Katherine]

Thank you Dr. Towfigh! I wish I could see you, but my insurance plan is not one that you accept. I appreciate your valuable input. I would say that at this point my hernia is mildly symptomatic – but the big choice is are the symptoms better now than they would be if I had chronic pain after surgery since there are no guarantees with surgery. I did see another surgeon who does only laproscopic mesh. I will post another topic in the forum in regards to that visit to get some educated opinions on the matter!

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