Mesh for Hernia Repair Reduces Recurrence: Study
But the open surgery technique increases odds of complications, researchers find
By Steven Reinberg
WEDNESDAY, Feb. 19, 2014 (HealthDay News) -- Using surgical mesh instead of stitches alone when repairing abdominal hernias appears to reduce the chances the problem will return, a new study suggests.
But mesh use is linked to other surgical risks, including infection, the researchers said.
"When repairing primary abdominal hernias, mesh reinforcement has the best long-term outcomes in most situations," said the study's lead researcher, Dr. Mike Liang, an assistant professor of surgery at the University of Texas Health Sciences Center at Houston.
An abdominal hernia occurs when the intestines bulge through a weak spot in the abdominal wall. Often, surgeons use a loosely woven sheet of flexible mesh to patch the weakness or plug up the hole instead of simply stitching it.
The advantage of the mesh is it allows the tension created by the repair to be spread across the abdominal wall, which in turn allows the patient to have normal movement after surgery, said Dr. Steven Hodgett, a general surgeon at Baptist Health in Jacksonville, Fla.
According to Hodgett, synthetic plastic mesh adds about $50 to $100 to the procedure's cost. Biological mesh could add more than $8,000, he said.
In the United States, more than 350,000 abdominal hernia repair surgeries are performed each year, according to background information in the study. Of these, 75 percent are known as primary ventral hernias (weakening of the abdominal walls, usually at the navel).
There have been two repair options, Hodgett said. One involves an open surgery and repairs the hernia with mesh and stitches. The downside of this procedure is that it increases the risk of infection, so it is not recommended for obese patients or others in whom the risk of infection is a primary concern, he said.
The other, less-invasive procedure, uses stitches alone. Because of the smaller incision, the odds of infection are lower, but there is a greater risk of recurrence, Hodgett noted.
"Hernia repair is a complex patient decision, but there are great options. It appears our ability to fix hernias is evolving as we try to bring our recurrence and complication rates down to zero," Hodgett said.