Hernia mesh is a piece of flexible plastic that is used to reinforce your hernia repair. Without mesh, there is only weakened hernia-prone tissue, and any repair based only on weak tissue has a higher risk of failure. The mesh itself looks like a window screen and functions like a scaffolding, allowing your body to weave scar tissue all through and around the mesh, creating a tough barrier of reinforced scar. This tough barrier is what reduces the risk of the hernia coming back again (for groin hernias this risk is about 2% with mesh vs. 25-50% without mesh, for belly (ventral) hernias this risk is about 10% with mesh, vs. 25-50% without mesh).
Mesh is used in over 90% of hernia repairs in the US, and we do over 1 million hernia repairs here every year. This has been the case for many years, which means there are millions of people walking around with hernia mesh, and the vast majority of these people have no problem from the mesh, they don’t even know it’s there. But if you turn on your TV you will likely see scary commercials about mesh. It is important to understand there is now a cottage industry, sometimes operating with questionable ethics, that encourages patients to get unnecessary surgery for mesh removal even when the mesh is causing no problem, because this leads to higher payouts in court. Removing mesh is a complex procedure that carries significant risks, not the least of which is the return of the hernia. If you have a mesh implant that you believe is causing a problem, it is imperative that you see your surgeon or another licensed surgeon in your community.
This is not to say that there are no problems from mesh. Anything we do in medicine and surgery carries risks, and mesh is no different. But by following established practices we can mitigate most of the risks associated with mesh, so the true risk of mesh complications from hernia surgery is very low. For example, we must prevent the mesh from sticking to your bowels. To accomplish this, we will place the mesh in between the layers of your abdominal wall, so it is sealed away and cannot touch anything inside your belly. Sometimes we use mesh with a special non-stick coating for this purpose as well. The coating is temporary, but over the first few months after surgery your body will regrow a new inner layer to cover the mesh.
It is important to also understand that there are many different meshes, made of different materials and used for different jobs within the human body. Some types of mesh, and some jobs mesh is used for, are more problematic than others. The two most popular types of mesh are made from polypropylene plastic and polyester. Your surgeon should have a detailed discussion with you about which mesh they will use and why.