Mesh and No Mesh Hernia Repair
When a hernia is symptomatic and causes detrimental health complications for an individual, surgical intervention is necessary in order to repair it. The goal of hernia repair surgery is to close and support the weakened area in the abdominal wall. The opening of the hernia can be reinforced using mesh or the body’s own tissues.
Mesh hernia repair reinforces the tissues of the abdominal wall using mesh. Mesh can be made from animal tissue derived from the skin or intestines, or it can be created from synthetic material. Mesh made from animal tissue is absorbable, while mesh made with synthetic material can either be absorbable or nonabsorbable. No mesh hernia repair, or repairing a hernia without mesh requires extensive training and experience to achieve careful and successful closure of the abdominal wall tissues.
Why Mesh and No Mesh Hernia Repair Are Performed
A hernia develops from a weakness in the abdominal wall that compromises the integrity of the muscles and forms a gap. This weakness allows abdominal tissues, or sometimes the intestines, to protrude into this opening. If left untreated, hernias can cause serious health complications, such as infection and/or loss of blood to the intestine.
The repair method used to treat a hernia will be decided based on the patient’s symptoms and the specific diagnosis. Mesh may provide necessary reinforcement when no mesh repair methods are not able to, either due to the size or the complexity of the hernia.
Hernia experts at MedStar Washington Hospital Center are committed to tailoring hernia repair surgery to each patient. Our surgeons are highly skilled in mesh and no mesh repair techniques for even the most complex hernias. Each hernia diagnosis is unique. For this reason, we take a comprehensive approach to hernia repair. We personalize treatment for each individual based on his/her symptoms and the complexity of the hernia.
What to Expect During a Mesh or No Mesh Hernia Repair Procedure
A mesh or no mesh hernia repair can be performed using the following surgical techniques:
The objective of hernia repair surgery is to treat open wounds in the abdominal wall, repair the gap, and return the protruding tissues and organs to their natural position.
During a hernia repair, the tissues of the abdominal wall will be closed, secured, and reinforced. In an open mesh repair, the hernia can be supported with mesh from the inside and the outside of the opening. In a laparoscopic and robotic mesh repair, the hernia is secured with mesh from the outside of the hernia.
In a no mesh repair, regardless of the technique, the hernia is closed and secured by carefully stitching the tissues of the abdominal wall closed. In severe cases where the opening of the hernia is quite large, a skin graft, taken from another location in the body, may be necessary in order to properly close the wound.
Risks Associated with Mesh and No Mesh Hernia Repair
Non-absorbable synthetic mesh acts as an implant and can come with the risk of certain complications. As with any type of implant, a foreign material may elicit an immune response from the body and therefore, rejection of the object. If the body rejects the mesh implant, additional surgery may be required.
No mesh repair is sometimes associated with a tugging or pulling sensation, and, if severe, this tension can even cause the muscles of the abdominal wall to reopen.
Benefits of Mesh and No Mesh Hernia Repair
Absorbable mesh made from animal tissues or synthetic material is intended to reinforce the tissues of the abdominal wall while also allowing for natural tissue growth. This type of mesh will eventually dissolve and the body will rely on its own mechanism to keep the repair strong.This allows the body to heal the hernia, but without the need for a permanent implant.
Non-absorbable mesh made from synthetic materials is considered an implant, and is intended to provide long-term reinforcement to the abdominal wall.
Mesh made of either material can significantly reduce the risk of a recurrent hernia. However, mesh is not required in order to close the opening in the abdominal wall. A no mesh procedure uses nothing more than the body’s own tissues, which reduces the risks associated with implants, such as rejection.
How to Prepare for Mesh and No Mesh Hernia Repair
Before any hernia repair procedure, the doctor will analyze the type and complexity of the hernia using diagnostic imaging techniques such as an MRI and/or CT scan. The diagnosis will dictate the type of surgery appropriate for repair as well as which procedure will produce the best results for the patient.
Pre-procedure instructions will be given to the patient by the surgeon, but will typically include refraining from eating or drinking at least eight hours before the operation. Patients who smoke will be asked to stop smoking at least two weeks before surgery. Smoking restricts oxygen flow in the body and impairs the body’s ability to heal itself.
Patients should discuss all current prescription medications with their doctor. Certain medications can affect the body’s ability to clot blood, which can lead to complications during and/or after surgery. The surgeon may provide specific instructions regarding medications for the days preceding the operation.
Post Mesh and No Mesh Hernia Repair Treatment
Recovery will vary for each patient, depending on the type of surgery performed and the overall health of the patient. Some patients may experience a low level of pain after an open repair procedure, while others may experience a high level of pain and discomfort after a laparoscopic procedure.
Depending on the extent of the surgery and the complexity of the hernia, patients may be required to stay in the hospital for a few days. In the case of a minimally invasive laparoscopic procedure, patients can even go home the same day. Patients will be able to return to daily activities with one to four weeks, but will need to wait at least six weeks before returning to vigorous exercise.
It is important to follow all postoperative instructions given by the surgeon as well as attend all follow-up appointments. Doing so will reduce the risk of complications and help patients recover more quickly.