If you review the literature, you will find that there are over 20 different ways to fix a hernia. No wonder many surgeons do not know what is going on and it makes almost impossible for the patient to fully understand the options and to make an informed decision.
To simplify the situation try to think of a hernia as simply a hole in the muscles. All the hernia repairs can be then organized into two basic types:
- The Pure Tissue Repair. The surgeon uses the patient’s own tissues to repair the hole.
- The Mesh Repair. The surgeon uses a piece of mesh to cover or patch the hole. The mesh can be placed on top of the hole to patch the hole from the outside or the mesh can be placed deep to the hole to patch the hole from the inside.
Most surgeons prefer The Mesh Repair. That is because the operation can be done very quickly; often in less than 20 minutes. The recurrence rate is low. Unfortunately, a significant number of patients will have chronic pain from the mesh. And that pain can be devastating. The mesh is very difficult to remove. Even worse, most surgeons do not know how to remove the mesh that they put in.
I prefer The Pure Tissue Repair. The hernia or hole is closed by using sutures. No mesh is needed. The operation does take longer and the operation requires complete knowledge of the anatomy. But the results are excellent. And the patient does not have to worry about having to suffer from chronic pain. The sutures dissolve with time and thus there is nothing that ever has to be removed.
I strongly advise patients to get all the information they can before they let a surgeon put mesh in.