Hernia Mesh Surgery

Hernia mesh surgery is a procedure to correct tissue or organs protruding through a weak spot in the surrounding muscle or tissue. Surgeons use surgical mesh made from biological or synthetic materials to cover the gap. They attach this medical device with sutures or staples. The tissue then grows into the mesh to reinforce the muscle wall.

Doctors perform more than 700,000 surgeries for inguinal hernias annually in the U.S. Surgery options with or without mesh depend on the size and location of the hernia. Most hernia surgeries in the U.S. use mesh, as this repair method can minimize recovery time and reduce recurrence.

“The surgeon also needs to determine that the benefits of the surgery outweigh the risks,” Dr. Mazen Al-Mansour, a hernia surgeon at the University of Florida College of Medicine, told Drugwatch. “For example, if the patient has other health issues, [such as] heart and lung conditions that deem the surgery too risky, then surgery is contraindicated.”

Surgery is the only way to correct a hernia permanently. Before the use of hernia mesh, recurrence was the primary complication for patients. Medical literature consistently finds that mesh surgery reduces the likelihood of developing a hernia again.

Other factors can affect outcomes, such as the patient’s overall health, the surgical approach and the mesh type. Hernia mesh manufacturers have recalled certain kinds of mesh because of increased failure rates that led to complications and the need for hernia mesh revision surgery.

Surgical mesh creates a flexible scaffold to prevent organs from pushing through muscle walls. General surgeons attach the mesh over the open hernia using sutures, adhesive or staples. Following the surgery, the patient’s tissue grows into the small holes of the device, strengthening the muscle wall.

Most mesh surgeries take anywhere from 30 minutes to two hours. Anesthesia type and operation time vary.

Many hernia operations use mesh reinforcements, regardless of surgery type. Mesh hernia repairs are usually permanent, meaning the device stays in the body. However, biological and absorbable synthetic meshes are intended to integrate with the body’s natural structures, eventually being replaced by the body’s own tissue.

These surgeries can prevent the condition from worsening and minimize the chance of recurrence. Hernia surgery (herniorrhaphy) provides the only permanent solution for correcting a hernia.

Technological advances have made way for new mesh-placement methods, such as enhanced-view totally extraperitoneal (eTEP), endoscopic mini/less open sublay (EMILOS) and endoscopic totally extraperitoneal approach (TEA).

Studies suggest that the TAPP method has higher rates of abdominal visceral injuries and port-site hernias. A port is an opening in the abdomen through which instruments are inserted during laparoscopic surgery. Surgeons consider TEP a more complex procedure but one with fewer potential complications. However, both TAPP and TEP have steep learning curves.

Enhanced-view totally extraperitoneal surgical repair typically has a quicker recovery and less postoperative pain than IPOM, and a study indicates it can be more cost-effective. However, data also shows that IPOM is easier and faster than other laparoscopic hernia surgeries. Further study is needed to evaluate the differences.

For any of these mesh placement techniques, the surgical approaches available are laparoscopic, open, and robotic. While we focus on mesh repair in this article, hernias can be repaired with or without mesh.

Laparoscopic Surgery

Laparoscopic repair is a minimally invasive technique using small incisions, a telescope-like tool called a laparoscope, a camera and mesh. Typically conducted under general anesthesia, a surgeon makes incisions, then inserts and secures the mesh to cover the defect. Surgeons can also perform this technique without mesh.

The laparoscopic surgery technique has many benefits for the patient’s recovery. It offers quicker recovery, smaller incision sites and less pain than open surgery. Doctors use this method for different hernia types, such as umbilical, inguinal, ventral or incisional.

A 2024 study published in Surgical Endoscopy found that using mesh in laparoscopic hernia repair surgeries carries a low risk of complications of less than 1%. Patients who had the surgery experienced improved quality of life. Another study evaluating the use of Progrip mesh for laparoscopic inguinal hernia repairs showed a hernia recurrence rate of only 0.2%.

Open Repair Surgery

Surgeons can perform an open repair hernia surgery with or without surgical mesh. A surgeon makes an incision over the hernia site, pushes the bulging parts into place and affixes mesh to the healthy surrounding tissue.

Surgeons commonly use open repair procedures to treat hernias. However, there are advantages and disadvantages with this approach.

This procedure cuts through more muscle and requires a longer recovery than laparoscopic surgery. It can also increase the risk of blood loss, pain and infection. Open repair techniques are generally less expensive than laparoscopic approaches.

Surgeons commonly use open repair procedures to treat hernias. Making one long incision does increase the risks and recovery time. However, this approach enables doctors to place two mesh pieces on each side of the hernia, providing extra support to the weak muscle.

Robotic-Assisted Surgery

Robotic-assisted surgery is a newer technique using small incisions, a laparoscope and robotic surgical instruments. The surgeon controls the tools from a console in the operating room. This method provides 3D images of the defective area, offering doctors a more comprehensive view.

The instruments used in robotic hernia operations are smaller and easier to maneuver than other tools, allowing for greater precision. This approach can result in less blood loss, reduced tissue damage, and lower levels of pain. If hernia mesh revision surgery is necessary, both laparoscopic and robotic approaches are effective options.

Most hernia surgeries in the U.S. use the open repair method. Many patients go home on the same day as the procedure.

Patients often wonder if you can feel the mesh after hernia surgery. People will likely have tightness, pain and swelling near the mesh site, but these issues should normally subside during recovery. The patient should monitor symptoms and contact a doctor if symptoms are unusual or worsening.

New Choice Health states that the average cost of a hernia repair in the U.S. is $7,750. Open repair generally costs less than laparoscopic hernia repair.

Prices vary depending on the patient’s insurance, the procedure type and the surgeon’s experience level. Inpatient procedures are significantly more expensive than outpatient surgeries. Prices also differ by location.

Patients may encounter hernia mesh complications that require hernia mesh revision surgery to repair the damage.

The success of hernia mesh surgery, and the risk of complications depend on several factors such as the the type of hernia, the size of the defect, the approach and technique used, and individual patient characteristics (e.g., obesity).

“Successful hernia repair can range from 97% for small inguinal, umbilical and epigastric hernias to 75% for parastomal hernias and large incisional hernias,” Al-Mansour said.

While hernia mesh repairs generally have a favorable rate, certain types of mesh have been linked to higher rates of complications. This has led some patients to file hernia mesh lawsuits.