How Hernias Form:
As discussed elsewhere on our website, hernias are caused by a tear in the muscles of the abdominal wall. Once the muscles tear, fat and internal organs push through the muscles to create a ‘hernia’. However, before the hernia completely develops, there is often a period of prolonged weakening of the muscle over many years. After some amount of time, ultimately the muscle gets to the point of being too weak to support the internal organs, the muscle tears, and a hernia develops. Therefore, it’s important to understand that hernias are not usually just a simple tear in the muscle which is surrounded by normal healthy muscle. There is usually a surrounding area of muscle weakness around the actual hernia.
Why ‘Primary’ Repair or ‘Tension’ Repair, doesn’t work:
Over many years and through 100’s of medical studies, surgeons have learned that when the muscles around a hernia are simply sewn back together and closed ‘primarily’ (tension repair), hernias recur at a very high rate. This makes good sense since hernias develop due to a weakening in the muscles all around the area of the hernia. By simply sewing these weakened muscles back together, surgeons basically are just pulling together thin, damaged muscles to repair the hernia. Over time, the muscles continue to weaken, the tear in the muscle returns, and the hernia ‘recurs’.
Why Mesh is Used:
To help reinforce weakened muscles in the area of a hernia, meshes were invented to implant into the surgical site. By implanting a mesh into the area of weakened muscles, the body creates scar tissue which brings strength back to the weak damaged muscles around a hernia. Medical studies have shown that long term recurrence rates of hernias repaired with mesh (tension free) are about 10x LOWER than those hernias repair ‘primarily’ (tension repair). Most studies show a recurrence rate of about 20% without mesh, and about 2% with mesh. Thus, 1 out of every 5 hernia patients who don’t have mesh used have a recurrence of their hernia.
Risks of Mesh:
When mesh was first invented for hernia repairs, the materials used to create the mesh were very stiff, hard pieces of plastic. With time, these pieces of plastic contributed to chronic pain and nerve injury in the groin. In the past, some mesh used for non-hernia related surgeries had metal pieces within them which over time eroded into the intestines. Most lawsuits due to mesh was from these types of metal reinforced meshes and not meshes used for hernia repairs. Today, these types of hard plastic meshes, and metal containing meshes are NOT used, especially for hernia repairs. Thus, patients should separate the risks and ‘lawsuits’ due to older types of mesh, and non hernia meshes, from what is used by hernia surgeons today.
Use of Lightweight Mesh:
Over the last couple of years, hernia surgeons who specialize in hernia repair have adopted the newest types of mesh. Although prior hernia mesh was heavy, thick plastic, today’s newest mesh is ultra lightweight. This means that it is soft, and flexible like the muscles themselves. It causes much less scar tissue within the body which decreases the chances of acute and chronic pain after hernia surgery. Over time, the mesh remains soft and flexible minimizing the chances of chronic pain to almost zero.
Our Philosophy:
Although some centers feel that they can repair hernias without mesh, the physics behind hernia formation and a large volume of medical studies has shown that mesh repair is strongly preferred. Today, the use of the newest and lightest weight mesh reduces the chances of mesh complications to almost zero.
Centers Which Don’t Use Mesh | California Hernia Specialists |
---|---|
Considered a ‘Tension’ repair because the muscle is pulled together under tension. | Is a ‘Tension Free’ repair because the muscles are not completely closed around the mesh. |
Over time the muscles around the hernia continue to weaken. | The muscles around the hernia are reinforced by the hernia mesh. |
Recurrence rates of 20%. | Recurrence rates of less than 2%. |
Significant pain after surgery due to the tension on the muscles. | Much less pain after surgery because the muscles are not pulled together which causes pain. |
Requires open hernia repair surgery. | Allows the use of laparoscopic hernia repair when desired. |
Dr. Harris can discuss these items during your consultation to decide which method is best for you. Although basic open surgical hernia repair is still an important option for some patients, every patient should consider being seen by a surgeon who can perform advanced laparoscopic hernia surgery and who uses the newest lightweight mesh. Only a small handful of the hundreds of general surgeons in Orange County, Los Angeles, Riverside and San Diego have the experience to perform hernia surgeries using laparoscopic techniques and use cutting edge lightweight mesh. In the short video below, Dr. Harris discusses some of the information above about mesh and why it is the preferred method for hernia repair.
Dr. Harris sees patients from Orange County, Los Angeles, Riverside, and San Diego. Our Newport Beach office is conveniently located in Central Orange county adjacent to John Wayne Airport between the 405, 73, and 55 highways. Our office staff are experienced in verifying insurance coverage for each patient, as well as offering excellent pricing for patients without insurance (see costs above). We are happy to discuss all forms of payments with patients as needed.