Hernia Surgical Mesh
Hernia occurs when a tissue or an organ bulges through a weak point or a tear in the abdominal muscle; this can also occur in the inner groin or the outer groin and even in the belly button or at a scar that is caused due to an incision. The hernia mesh is a screen-like surgical implant that is used to repair these hernias. Repairing a hernia is very common procedure as this is a painful disease to have. Surgery is the only option for a hernia to be fully cured however the doctors usually choose to monitor a hernia in cases where the hernia cannot cause any more problems or is not getting any bigger. However, the rate of recurrence of a hernia is very high and thus more doctors prefer to use the hernia mesh to repair the damaged muscles which helps decrease the rate of recurrence better than just sewing the damaged muscles together. The surgical mesh helps to strengthen the weak muscles.
What is a Hernia Mesh?
This is a sort of screen that is used to patch up a weakened muscle where a hernia is developed. This can be made up of either animal tissue or a synthetic material. This mesh comes in a variety of sizes that can range from small patches to plugs or even larger sheets of mesh to strengthen larger areas. This mesh acts as scaffolding and helps the muscles repair themselves.
Synthetic Hernia Mesh
Theses can come in different types mainly those that are woven or those that are non-woven sheets. The synthetic material can be either absorbent or non-absorbent or can even be a combination of both. A surgical mesh made up of a synthetic plastic called polypropylene is one of the most common types that are used by many doctors. Other synthetic materials may include coating with organic substances such as fatty acids, celluloses or even collagen.
Animal tissue mesh
This type of mesh is made up of animal skin or intestines that are often got from pigs or cows. The animal skin and intestines are processed and disinfected so that they can be easily implanted into humans. Animal tissue meshes are always absorbable.
An absorbable mesh is one that will be degraded in the body over a period of time and it will not give any long-term protection from hernia.
The hernia surgery that involves the use of a hernia mesh is known as hernioplasty,
the use of these meshes started in the 1940s so as to prevent the recurrence of hernia
in an individual. From the 1980s the rate of use of these meshes increased to a great
level and by 1989 the surgeons used laparoscopy surgeries to minimize the amount of
invasion in the body.
Repair techniques for hernia
There are three main techniques for hernia repair
- Transabdominal preperitoneal (TAPP) — this is a technique in which the surgeon enters into the peritoneum and places the mesh through a small incision.
- Totally extraperitoneal (TEP) — the surgeons do not enter the peritoneum in this method but place the mesh from the outside. Although, this method has fewer complications this is a harder procedure to carry out.
- Intraperitoneal onlay mesh technique (IPOM) — this is the fastest and easiest method for implanting hernia filters and has grown in popularity from the 1990s. The surgeons enter into the peritoneal cavity and place the mesh inside the peritoneum in direct contact with the intestines and other organs.
FDA warned doctors that the use of these hernia meshes may not always be the right treatment for the patient. They said that despite the proof of reduced rates or recurrence in a patient that had a hernia mesh implanted it may not be a recommended treatment for everyone. The patients were advised to talk to their doctors about their condition and all the options that they have.
Complications That Can Occur Due To Hernia Mesh Surgery
The complications that can arise from having a hernia mesh implanted into the body is mainly related to which procedure the surgeon decides to use. The patients who experienced side effects from this surgery usually recovered quickly, however, there were various reports of more severe adverse for a few patients.
The following are the some of the adverse effects that were reported by the patients
- Pain and bleeding in the area where the mesh was implanted
- Infection caused due to the mesh
- Recurrence of hernia
- Various adhesions
- Shrinkage of the mesh
- Blockages in the intestine that caused constipation
- Oral perforations
- Damage to the nerves
- Autoimmune reactions that can be caused due to the implanted mesh
- Migration and rejection of the mesh
- Tenderness in the area of implant
These complications can remain for up to 5 years after the main surgery and out of the 3242 cases that were studied 1050 patients needed subsequent abdominal surgery.
Symptoms that Indicate Complications in the Hernia Implant
There are no physical symptoms that can indicate that the patients are suffering complications regarding hernia implants. However, these complications can be identified after the patient has undergone a blood test. For example, an increase in the white blood cell count can indicate an infection in the mesh site; a lower hemoglobin count can indicate blood loss; an imbalance in electrolyte can reveal that the patient has a kidney problem, and finally elevated levels of enzymes can indicate a liver problem.
Recall of the Hernia mesh
The FDA recalled the hernia meshes from various manufacturers and also issued a safety communication in 2014 to warn the general public about the side effects of this mesh. Some of these devices were recalled due to errors in packaging, while others were recalled due to the adverse effects such as mesh perforation. Many patients who suffered the ill effects of the mesh filed cases against the manufacturers for misinformation and hiding these risks. The companies that had to recall their products included Brad Davol, Ethicon, and Atrium Medical Corporation.