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.

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