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Hernias are a common health problem that occurs when the intestines or other organs push through the wall of muscle and fibre that generally contains them. For the different kinds of hernia, there are different methods and surgical approaches to repair them. For the past few decades, surgeons have been using a surgical mesh (a loosely woven sheet). It could be synthetic or biological (derived from cow or pig tissues).
However, in recent years, concerns have been raised regarding the safety of surgical mesh used in hernia repairs.
Is surgical mesh safe?
Some surgical mesh products utilized in hernia repairs created problems and this has been the major subject of recalls by the U.S. Food and Drug Administration since March 2010.
The first question directed by patients is regarding the safety of the mesh used in repairing hernias, says Dr. Manas Ranjan, a specialist in gastrointestinal and bariatric surgery. “We cross-check both the risks and gains and discuss the reasoning behind using mesh. This helps them to make informed and right decisions” answers Dr.Manas Ranjan.
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How Do Hernia Mesh Implants Work?
Through hernia surgery, the bulging or protruding tissues are pushed back in. Later, the holes in the abdominal wall are closed up with stitches or sutures. In more than 50% of cases, the surgeon might also use a flexible sheet of woven mesh to provide additional support to the damaged tissue.
Some studies have shown that using mesh in surgeries lead to fewer hernia recurrence. Due to the lower rate of hernia recurrence, many surgeons rely on using mesh. However, the mesh is also associated with a lot of complications. Another study observed that the rate of complications was prominently higher in patients with surgical mesh implants than those with mesh implants.
Typical Hernia Mesh Surgery Recovery Timeline
DAYS 1 TO 4
- Patients aren’t supposed to return to work or school during this period.
- They should only perform basic daily activities such as walking around the house.
DAYS 4 TO 7 (50% OF NORMAL CAPACITY)
- By the fourth day, most patients can return to work or school.
- After surgery, patients are suggested to avoid lifting anything over 15 pounds
- They can expect to still feel slight pains.
- Walking and light stretching is recommended by doctors during this time.
WEEK 2 (75% OF NORMAL CAPACITY)
- By this time, all patients should resume their job or classes.
- Avoid lifting anything beyond 20 pounds
- They can perform activities like jogging, yoga, tennis, biking, and pilates.
- Patients are expected to feel some soreness and stiffness.
WEEK 3 (85% OF NORMAL CAPACITY)
- Can perform exercises including running, swimming, cycling, surfing, and golf.
- Patients no longer need to consume pain medicines.
- The limitations in lifting apply the same.
WEEK 4 (95% OF NORMAL CAPACITY)
- Lifting limitations no longer apply.
- Patients can resume all kinds of athletic activities, even contact sports and heavy lifting.
- They can expect some sharp pains and some small discomfort occasionally.
- When the pain recedes, patients can resume sexual activity.
Benefits and risks of using mesh
The major benefit of employing a mesh is that it holds the damaged tissue together and also strengthens it as it heals. Consequently, it minimizes the chances of hernia recurrence.
“Mesh, when adopted and positioned correctly, will help in reducing the risk of recurrence for most types of hernia. Therefore, there will be minimal risk of complications,” states Dr.Manas Ranjan.
According to him, the classification for the risk of recurrence after hernia repair surgery follows this way:
● High: Stitches without mesh
● Medium: Stitches with biologic mesh
● Low: Stitches with synthetic mesh
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Most problematic mesh has been recalled
The Most Common Hernia Mesh Complications :
● Pain
● Infection
● Hernia Recurrence
● Adhesion
● Bowel Obstruction
If the patients experience specific symptoms following hernia repair surgery, then they should contact their doctor immediately as these signs could be some serious hernia mesh complications.
Serious Complications After Hernia Mesh Surgery:
● Experiencing sudden increased pain at the surgical wound.
● Finding increased redness or soreness at the incision
● Bleeding at the surgical site
● Nausea or vomiting
● High fever (more than 101 degrees)
● Trouble while urinating
● Facing excessive swelling or bruising at the cut or incision
Apart from this, another complication is that the mesh may migrate or shrink.
According to the FDA, most complications reported to the agency relate to mesh products that have since been recalled.
“Like every other thing, the mesh has also got some risks,” acknowledges Dr.Manas Ranjan. He adds “Further that risk also depends on other factors; the kind of hernia, its site, the way it is placed, and whether the hernia surgery is an emergency or nonemergency one.”
Research on mesh usage ongoing
Research published in the Journal of the American Medical Association (JAMA) in 2014 analyzed some 2,000 surgeries from 1980-2012. This research indicated that the use of surgical mesh results in fewer recurrences of hernias over five years.
But a 2016 study published in JAMA has found that for those people whose hernias occur at the site of former abdominal surgery, the long-term success of surgical mesh may be “offset in part by mesh-related complications.”
Conclusion:
According to Dr.Manas Ranjan, mesh does offer benefits.
“Mesh is required in certain hernias. When placed correctly — and under the right circumstances — it is safe,” he asserts.
