Hernia Mesh

Hernia mesh is a net-like implant, often made from polypropylene plastic, treats hernias. It prevents the tissue, organs or fat from bulging through weak muscle walls. Doctors commonly use mesh to treat patients with hernias because of the low hernia recurrence rate.

While typically a safe procedure, there are possible complications, including infection, chronic pain, hernia mesh failure and hernia recurrence. These can lead to additional surgeries. Patients should discuss possible complications and surgery alternatives with their doctors.

Hernia mesh can successfully repair hernias, but there is the possibility of complications. Infection, for example, is a risk. One study found that when infected hernia mesh was tested, staphylococcus aureus was present in 64% of those cultures, meaning staphylococcus aureus was the primary driver of the tested mesh infections.

Sometimes, the risks of hernia mesh may outweigh the benefits. The likelihood and severity of complications depend on the material of the mesh, the surgeon and surgical technique and the response of the patient’s body.

Research estimates that less than half of patients choosing mesh repair require repair surgeries, with non-mesh or suture-based repairs experiencing higher recurrence rates. The ideal hernia mesh resists infection and an inflammatory response, while staying flexible and quickly incorporating into the body’s tissue.

Non-absorbable hernia repair mesh should be a permanent fix, but absorbable mesh typically dissolves in six to 18 months. Hernia recurrence is possible even with non-absorbable mesh.

Research suggests that mesh materials may affect recurrence rates after hernia repair. Polypropylene mesh is extremely durable, but because of its heavy weight, it can lead to inflammation in the area. This has a shrinking effect on the mesh, creating higher recurrence rates.

The FDA is aware of complications arising from recalled meshes and current market products. While many people experience improved quality of life following hernia treatment, others report mild to serious complications.

You may experience symptoms such as fever, flu-like symptoms, nausea, vomiting or constipation. Other signs of hernia mesh failure include chronic pain and severe swelling or tenderness at the surgery site.

Hernia mesh failure can happen a few weeks or a few years after your surgery. Talk to your doctor as soon as you notice something wrong or out of the ordinary after your hernia surgery.

Hernia mesh materials fall into different categories: Synthetic, biological, coated, composite and hybrid meshes. Mesh is available in different weaves, sizes and strengths and is available as patches, plugs and sheets.

Different mesh materials lead to different rates of complications. In an April 2023 meta-analysis, researchers formed a conclusion that biologic meshes increase the complications of surgery site infections and hernia recurrences. As an alternative, uncoated, macroporous synthetic mesh is suitable for open ventral hernia repair.

Biologic hernia mesh uses animal or human donor tissue, often decellularized intestines or skin of cows and pigs. The material breaks down over time and absorbs into the body.

A surgeon may choose this mesh for a strangulated hernia or if there is an infection in the location. Recurrence is a potential complication.

With a synthetic mesh, a surgeon could use a woven or nonwoven sheet. These materials remain in the body indefinitely and include polyester, polypropylene or expanded polytetrafluoroethylene. These types of mesh are chemically inactive and should minimize reaction complications.

While polypropylene is one of the more common mesh materials, it can wear away or break down over time. If this occurs, the mesh could protrude or cause injury to surrounding tissue.

These materials have non-absorbable or absorbable coatings such as cellulose, beta glucan, omega-3 fatty acids or collagen. The coatings minimize the body’s inflammatory response.

A leading benefit of choosing a coated or composite mesh is the ability of surgeons to use it in intraperitoneal space with little adhesion formation risk. Studies show varying degrees of inflammation risk from composite mesh, depending on the materials used.

Glue fixation had shorter operating time and lower haematoma formation than suture fixation. Chronic pain and seroma formation were comparable.

Evidence to support less chronic pain with glue is not very strong. It mostly comes from the shorter operating time and less trauma during the procedure.

Several manufacturers voluntarily withdrew or recalled their hernia mesh from the market. Some actions were initiated because of packaging errors, higher than normal failure rates or the risk of serious complications such as adhesions, pain and hernia recurrence.

A company will voluntarily withdraw a product when the violation is minor and not subject to legal action from the FDA. A drug or device recall occurs when there is evidence or a belief that the product is harmful or defective.

There are currently more than a dozen major hernia mesh manufacturers dominating the U.S. market. Product options come in various sizes across brands.

Manufacturers that issued a recall for one or more of their hernia mesh products include Atrium Medical, Bard Davol, Ethicon/Johnson & Johnson and Covidien/Medtronic. If you have questions about which hernia mesh was used in your surgery, your surgeon’s office will be able to confirm that information for you.

Thousands of hernia mesh lawsuits accuse manufacturers of producing devices that caused serious complications. Four major mesh makers are at the center of separate multidistrict litigations, large court actions that combine similar lawsuits in a single federal court. In MDLs, plaintiffs receive a portion of the settlement award, often based on the severity of their case.

Hernia mesh manufacturers often settle out of court with plaintiffs to avoid going to trial. In February 2023, the Attorney General for the state of Kentucky announced that Ethicon settled litigation for close to $10 million.