Why is needlescopic hernia repair not performed on adults?

[RJ]

This could be a dumb question, but why is needlescopic hernia repair limited to children and not offered to adults? It seems like it has so many benefits, near immediate recovery, no mesh risk, basically no chronic pain risk, very low recurrence, etc

Here’s a video of a needlescopic repair for those wondering, it looks like it’s basically a laparoscopic tissue repair to close the hernia defect:

https://www.youtube.com/watch?v=HWxr5OYZJKs

[drtowfigh]

Why is needlescopic hernia repair not performed on adults?

Easy answer: adults are not larger children.
In children: Hernias are anatomical failures to close. The tissue itself is otherwise normal. If you close it surgically, it will heal.
In adults: Hernias are structurally abnormal tissues. They have poor collagen content. The tissue is weak. If you close it like in a child, it will reopen. It needs a mesh to facilitate its closure or strengthen the tissue. Or you need to close it with multiple layers of overlap and accept that a proportion of them may still fail and need mesh.

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