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Dr.Chirag Thakkar
A diagram of a strangulated hernia labels key parts, while a photo shows Dr. Chirag Thakkar repairing it with surgical mesh

Is Mesh Necessary for Hernia Surgery? Risks, Benefits, and Expert Insights

Is Mesh a Must for Hernia Surgery?

Table of Content:

Living with a hernia can be uncomfortable and worrying. When Dr. Chirag Thakkar sees patients concerned about hernia repair, he knows their biggest questions revolve around one critical topic: surgical mesh.

“Patients are often scared of what they don’t understand,” says Dr. Chirag Thakkar, a leading hernia specialist. “My job is to demystify the process and help patients feel confident about their treatment.”

If you’re concerned about the use of mesh in hernia surgery, this guide will break down everything you need to know about surgical mesh and how modern medical techniques can help you recover.

The concern for mesh is justified, as mesh is a foreign body and is going to be there in the patient’s body for the rest of their life. But it is a fact that almost all hernia surgeries in today’s time are done using a mesh.

So, let’s discuss why mesh is almost universally used in hernia surgery. What is the reality about the risks of using the mesh during a hernia surgery? What decision should you take if you are planning a hernia surgery?

Why is a Mesh Used for Hernia Repair?

The surgery for hernia is mainly a surgery to repair a defect (a hole) in your tummy wall. It is a surgery to strengthen the wall of the abdomen (tummy). It can be done by a mesh repair or a tissue repair.

Tissue Repair in Hernia Surgery

An example of hernia repair surgery, featuring instruments and anatomical structures
In Tissue repair, stitches are taken in the body’s natural tough tissues called tendons, fascia and muscles. But such stitches would lead to a pull on these tissues. This will lead to repair under tension, which would not give adequate strength. This pull on the natural tissue is more when the hernia is large. At times these tissues are weak due to the ageing process, previous pregnancies, previous surgery and scar tissue, and other medical problems. At times there is significant loss of local muscles and tissue, where closing the hernia defect with natural tissue and stitches is not at all possible. These are all the reasons for poor strength with tissue repair and a very high chance of hernia occurring again even after a technically nicely done surgery.

Mesh Repair in Hernia Surgery

In Mesh repair, a mesh is used to reinforce the repair and support the local tissue. When a mesh is used, the tissues are not under tension or a pull, promoting a good healing process. It also becomes the scaffold over which the body will lay down the collagen to create a tough wall, giving good strength. The mesh would work like the steel frame in construction, which helps hold the cement and concrete. If we do surgery at the same place after a few months for any other medical problem, we would not find the mesh in the same condition as it was placed. But we would find mesh incorporated in the muscles and the healing scar tissue. Almost becoming the part of the body, giving strength to that part.

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Advantage of a Mesh in Hernia Repair

The recurrence rate with a mesh repair is much lower than the tissue repair. The invention of good-quality mesh has, in a way, helped to solve the troubling issue of hernia recurrence. The problem with recurrence is that each time a hernia reoccurs, it weakens the tissues further. Hence each subsequent hernia repair would be weaker than the previous one and have more chance of reoccurrence. So, the best chance to have a strong repair and a permanent solution is the first time the hernia surgery is done. And mesh helps in giving the best possible strength at the primary surgery itself, preventing recurrence.

The use of mesh does come with some of its problems.

Mesh Infection

Mesh infection is the commonest of the problems of using a mesh. This is one of the most feared complications. As the mesh is a foreign body, it does not get the blood supply like the normal body tissue, and hence, the immune cells and antibiotics cannot reach there. So, in case it gets infected, then the body’s immune system cannot fight with the infecting organisms. When infection of any foreign body occurs, medications are less effective. We will need to do another surgery and remove the mesh. The good thing is that mesh infection is very rare at hospitals where the sterilization protocols are followed appropriately. Once we have taken care of infection during the surgery time, and there is no infection in the initial days of surgery, then you don’t need to worry about the mesh infection.

Mesh Erosion

The other risk related to the usage of mesh is mesh erosion. Mesh erosion means mesh gets stuck to the vital body organs like the intestine, stomach, and urinary bladder and, over a period of time, erodes into the wall of these organs. At times it can lead to problems in these organs and would need surgery to remove the mesh and then repair the organ into which it has eroded. Again, this complication is very very rare, less than 0.1%. As surgeons, we always prefer to perform the surgery such that we keep the mesh away from these organs, with a layer of normal tissue between the mesh and these organs to prevent erosion. In situations where this is not possible, a two-layered mesh is used to prevent adhesions between the mesh and the vital organs.

What if We Chose Not to Use a Mesh?

If we want, we can choose to repair a hernia without mesh whenever it is possible. But that will increase the chances of reoccurrence. The benefit of a mesh repair is so high, and the chances of complications are so less that it doesn’t make any sense to do a surgery without mesh. In today’s time, almost no surgeon would do a hernia repair without a mesh, barring some very special situations.

What Types of Mesh are There? Can We Use Mesh That Will Get Absorbed Later?

Non-absorbable Mesh

Showcasing close-up of a light hernia with non-absorbable mesh
Meshes are made from Polypropylene or Polyester material, which is non-absorbable. They will stay in your body for the rest of your life after surgery. These materials are medical-grade plastic and have been used in hernia surgery for more than 30 years all across the world. This material has been proven to be inert and not cause any other effect on your body.

Two-layered Mesh

Showcasing two-layered mesh that is used in the intestine, stomach, or urinary bladder
Some meshes are two-layered; the second layer is a coating that is absorbable and helps to prevent adhesions between the mesh and the organs. Such a mesh is used when the mesh needs to be placed such that it comes in contact with vital organs like the intestine, stomach or urinary bladder. With the advancement in the techniques of hernia surgery and laparoscopic surgery, the need to put a mesh in contact with such organs is reducing day by day. In our practice, we try our best to plan surgery such that the mesh is placed away from vital organs.

Absorbable Mesh

Showcasing absorbable mesh that used in other surgical scenarios
Absorbable mesh, though available, is not used for hernia surgery. They are used in other surgical scenarios where the surgery is done for infection within the abdomen and it is not possible to close the abdomen due to various reasons. In such a situation absorbable mesh is used as a temporary measure to help close the tummy. It does not give lasting strength, but is still used because non absorbable mesh cannot be used when there is infection. Most such patients would need a re-surgery in future to repair the tummy wall.

Dr Chirag’s Recommendation- Take home message:

Suppose you need a hernia surgery, and your surgeon has suggested surgery with a mesh. In that case, my opinion is to go with your surgeon’s advice without the fear of mesh complications. It would help to get the surgery done at a standard hospital, that is following proper sterilization in their operation theatre. A hernia specialist surgeon would certainly be able to give you better results.

At our centre, we don’t use any antibiotics after surgery for the past 15 years. Even without antibiotics, we don’t see any mesh infection. We always try to place a mesh between two layers of muscles, keeping it away from vital organs, and we encounter no mesh erosion in our practice. After the procedure, we guide our patients on the best activity or exercise to do after hernia surgery to ensure a smooth recovery process. When it comes to finding the best hernia doctor in Ahmedabad, expertise matters.

Conclusion

Dr. Chirag Thakkar maintains that modern hernia surgery has come a long way, with surgical mesh providing safer and more effective treatment options.

Your health journey is personal. Whether you’re dealing with a small or large hernia, the right medical approach can make all the difference. Dr. Chirag’s approach focuses on patient education, precision, and compassionate care.

If you’re seeking the best hernia doctor in Ahmedabad, look for a specialist who combines medical expertise with a patient-first approach. Your path to recovery starts with understanding your options and working with a trusted medical professional. Get in touch with us.

You can book a video consultation with Dr Chirag Thakkar. Call on +91-8156078064 to fix an appointment.
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Dr Chirag Thakkar is a gastrointestinal surgeon. He has been carrying out gastro intestinal and weight loss surgery for the past 18 years. Surgery for GERD, hiatus hernia and Obesity are his core areas of interest and expertise. At ADROIT, we don’t just repair your hernia, but aim at restoring the patient’s best possible activity level after surgery and giving our patients a very smooth and comfortable surgery experience.

Dr. Chirag Thakkar
Best Hiatus hernia surgeon

Dr Chirag Thakkar
Senior Gastrointestinal and Bariatric surgeon
GERD and Esophageal Motility Expert
Hernia Surgery Specialist
Founder Director of ADROIT Centre for Digestive and Obesity Surgery