First, let’s understand the source cause of the hernia before knowing the possibility of hernia surgery without mesh. A hernia usually happens when your muscle wall becomes weak in your abdomen area. When the tissues in the muscle wall become weak, a small gap is formed and through the gap, the intestinal organs start to protrude out. It is known as a hernia.
The most common areas of hernia development are the groin area (inguinal or femoral hernia) and the belly button (umbilical hernia).
So, when a hernia need to be repaired, what is the procedure? The organs are pushed inside and the gap is closed with stitches. What happens if the muscle is unable to support the stitches? This is the situation where another reinforcement or support called mesh comes into play. The mesh is used in such places to provide extra support as muscle strength is not reliable. Even if you stitch the incision without reinforcements, after a while between 3 to 6 months, the stitched area might open out because the muscle becomes thinned out as it is naturally weak.
In such cases, doctors would suggest reinforcing the repair, with a prosthesis like a mesh.
Does everyone need a mesh to repair their hernia?
The first thing to note is that not all hernias need mesh to fix and cur it. However, the mesh is a priceless surgical tool that has given surgeons the ability to successfully treat hernias that were previously untreatable. Another crucial point to remember is that not all hernias can be fixed with the same kind of mesh; the options vary depending on the type of hernia.
Surgeons who are expertise in hernia repair know the natural limitations of mesh as a surgical tool. They are familiar with figuring out the best mesh for various hernia types, understanding potential patient-related complications with mesh products, and understanding the ways mesh can aid in the repair process by reducing the risk of recurrence and promoting optimal healing. It is possible to avoid using mesh in some situations while retaining an acceptable degree of recurrence risk, including minor umbilical hernias, specific hiatal hernias, and inguinal or groin hernias in infants.
Scenarios where hernias don’t need a mesh
The first scenario is a congenital hernia that doesn’t require a mesh to fix it. This type of hernia is usually observed in children or infants where there is no muscular defect. In the groin area, there exists a natural opening through which the testicles typically descend during birth. Generally, this opening closes on its own shortly after birth. However, if it fails to close properly, a hole remains open, resulting in the protrusion of the intestines. This condition is known as a congenital hernia. In such hernia cases, the primary objective is to reposition the protruded intestine and close the opening with a stitch. Since there is no muscle weakness involved in these cases, there is no requirement for the mesh to repair these hernias.
The second scenario is a traumatic hernia. In the event of an injury, particularly a stabbing wound to the abdomen, it has the potential to penetrate the abdominal wall, resulting in an opening through which the intestine may protrude. This scenario typically constitutes an emergency situation. Importantly, there is no inherent weakness in the muscle wall; rather, it is the result of an injury, trauma, or incision that has compromised the muscle’s integrity. In most of these cases, the displaced intestine is carefully repositioned, and the hernia is typically repaired primarily with stitches.
The third scenario is with an umbilical hernia also called belly button hernia. The region around the belly button generally lacks muscle structure. It serves as a natural weak point, through which the umbilical cord enters the body during fetal development. After birth, this opening is generally sealed with scar tissue or fibrous tissue. However, in some individuals, this scar tissue might be weakened, resulting in a small opening through which the intestines may protrude. This condition is known as an umbilical hernia. If the person possesses strong abdominal muscle tone and the hernia is small in size, it doesn’t require a mesh to be fixed; just stitches will do.
In certain cases, particularly among young individuals with strong muscle tone, even groin hernias can also be fixed without the use of a mesh. It’s crucial to remember that these situations are much less prevalent than the hernia instances we typically see. So, most of the patients might need a mesh to fix a hernia, although not all hernias necessarily require it. As mentioned above, there are situations where a mesh is not required, and a straightforward muscle repair with simple stitches is sufficient.
If you are looking for a hernia surgeon in Hyderabad, consider consulting Dr. Venugopal Pareek, one of the top surgeons for hernia repair in Hyderabad. He has nearly two decades of experience in fixing hernias with and without mesh. Call +91 91-777-77715 to book an appointment with the doctor.