Mesh Repair for Sports Hernia No Longer Preferred

Mesh Repair for Sports Hernia Continues to Lose Favor Amongst the Medical Community

dartmouth-shieldDr. Josef E. Fischer, Harvard Medical School professor, recently published an article in The American Journal of Surgery arguing against the use of mesh in sport hernia repair surgery. “Hernia repair: why do we continue to perform mesh repair in the face of the human toll of inguinodynia?” includes a summary of his personal experience and concludes that while mesh may decrease the chance for a recurrent hernia, that the potential problems far exceed its benefit. He advises that surgeons should return to the traditional, but well tested, open repair method.

As a Dartmouth grad myself, I hate to agree with someone from Harvard. However, I do in this case as this has been my experience as well, and why I’ve advocated the open repair procedure without mesh for many years now. If I’ve said it once, I’ve said it a thousand times; sports hernia repairs are best done without mesh. And now all of the surgeons that treat large numbers of sports hernia injuries are also taking the open repair approach.

The open operation and a laparoscopic procedure with mesh are two different surgical procedures used to treat sports hernias. Both deliver excellent results, but I prefer the open operation.

Why? Because I can fully evaluate and repair damaged muscles during an open procedure, along with assessing and treating the nerves and tendons. Mesh is not required in an open procedure. Unlike laparoscopic surgery that involves general anesthesia, the open procedure can be done using only sedation and local anesthetic. For patients that prefer it, general anesthesia is an option during open repair.

The laparoscopic procedure does not allow me to evaluate nerves and tendons because they cannot be seen in this case. Instead, the laparoscopic method uses a large piece of plastic mesh to reinforce the lower abdominal wall. This doesn’t repair the muscles, and the mesh is known to cause potential shear stresses and nerve damage. Plus, the mesh is very difficult to remove if problems arise later on.

In the event that additional treatment is required for sports hernia repair, adductor tenotomy or an ilioinguinal nerve neurectomy are options for a full recovery. But the first step for any athlete suffering from inguinal disruption (ID) is to seek an evaluation from a sports hernia specialist with a track record for successful and complete recoveries.

William Brown, MD
Hernia Specialist

Dr. Brown has been repairing inguinal hernias for over 30 years, taking care of Athletes with Sports Hernia injuries since 1999.  Dr. Brown has been taking care of patients with complications from mesh for so long that his hair is gray. Luckily he still has some hair.

His patients include players from the San Jose Sharks and the San Jose Earthquakes as well as athletes from the NFL, AFL, NBA, and the local college teams. As well as Athletes from 15 foreign countries.

Location:
Fremont Office
William H. Brown, M.D.
39470 Paseo Padre Pkwy
Fremont, CA 94538
(510) 793-2404
Fax: (510) 793-1320

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