More than 20 million hernias around the world are repaired every year. When an organ or fatty tissue pushes through opening in the muscle or tissue that holds it in place, a hernia occurs. Hernias can happen in the abdomen, belly button, upper thigh and groin area, with the majority being in the abdomen. According the FDA, the most common types of hernias are:
- Inguinal: occurs in the inner groin
- Femoral: occurs in the upper thigh/outer groin
- Incisional: occurs through an incision or scar in the abdomen
- Ventral: occurs in the general abdominal/ventral wall
- Umbilical: occurs at the belly button
- Hiatal: occurs inside the abdomen, along the upper stomach/diaphragm
Caused by weak muscles and strain, hernias can form quickly or over a long period of time. While most hernias are not immediately life threatening, they do not go away on their own and require surgery to prevent further damage to the body.
Hernia repair surgery is common, with over one million being performed every year in the U.S.
In order to help the muscle or tissue recover and rebuild from a hernia, surgeons will use mesh to act as a “scaffolding” to prevent organs from coming through. It is held in place by sutures, tacks or surgical glue.
Hernias have a high probability of recurrence, and doctors use hernia mesh to attempt to lower the odds of an organ protruding through tissue again. A 2014 study in the Journal of the American Medial Association concluded the use of hernia mesh in surgery drastically reduces the chances of recurrence than sutures alone.
Hernia mesh is commonly made of synthetic or animal material and can be absorbable, non-absorbable or a combination of both. Non-absorbable mesh is considered a permanent implant, staying in the body forever and being difficult to remove. Absorbable mesh is commonly made from the skin or intestines of pigs or cows. Over time, the patient’s actual tissue or muscle should grow through the mesh, increasing strength in the abdominal wall.
Hernia mesh surgery, called hernioplasty, was developed in the 1940s. By 2000, non-mesh surgery made up less than 10 percent of groin hernia repair techniques. Surgery with synthetic mesh is now the common practice to repair hernias.
Three surgical techniques involving mesh are used to repair hernias. Transabdominal preperitonea repair involves placing the mesh on the thin membrane covering the abdominal organs—called the peritoneum—through a small incision. The most difficult to perform, but with the least likelihood of complications is totally extraperitoneal repair, where surgeons place the mesh outside of the peritoneum. Intraperitoneal onlay mesh technique is the most infrequently used of the three, and the mesh is placed on the inside of the peritoneum in contact with intestines.