No Mesh Hernia Repair (Natural Tissue)

While there are many techniques used for inguinal hernia repair - some techniques are best matched with certain types of patients.
While it is not proven, many hernia experts agree that young, thin active people have a higher risk of pain or discomfort in the long term with the use of mesh. At the same time, it is clear that when mesh is used correctly in the right patient there is a lower risk of long-term recurrence of the hernia. In expert hands, laparoscopic and robotic techniques of inguinal hernia repair mesh placement has a risk of recurrence and complications of under 1 percent.

Despite our extraordinary results with laparoscopic and robotic techniques of inguinal hernia repair, it remains clear that the avoidance of mesh in some patients eliminates the risk of chronic discomfort or pain and with a small price of a slightly higher risk of recurrence. Therefore a non-mesh inguinal hernia repair may be the most "minimally invasive" option for some patients. The Shouldice and Desarda repair techniques are an excellent option for patients who desire a repair of their inguinal hernia without mesh.

The biggest variable after this surgery is the degree of pain after the operation.

90-95% of patients undergoing a non-mesh natural tissue inguinal hernia repair will experience mild to moderate pain in the first few days after surgery.  These patients are frequently able to avoid prescription pain medicine after surgery.

5-10% of patients will experience significant pain requiring prescription pain medicine.

99% of patients are comfortable at rest within 5 days of the operation and tolerate symptoms with ibuprofen and /or acetaminophen alone.

After surgery, you may expect to:

Return to an office-type job within 3-5 days after surgery depending on the level of discomfort.

Return to 30 lb lifting as soon as you feel comfortable.

Return to extraordinary physical activities performed by high-performance athletes and those with physically demanding occupations is dependent on multiple factors and is not uniform for all.

Overall - most patients find the Shouldice repair and Desarda repair of their inguinal hernia to be a good experience and easily tolerated.

Yes, it is possible to repair a hernia without using mesh. A no mesh surgical technique relies solely on utilizing the patient's own bodily tissues, thereby eliminating the potential risks associated with the use of artificial implants. Natural tissue repair (non-mesh) mostly refers to inguinal hernias of the groin. Ventral hernias involve the use of mesh almost universally. There is strong data showing the significantly lower risk of hernia recurrence when mesh is used. Very small hernias are potentially well treated without the use of mesh.

A non-absorbable mesh stays in the body permanently and is considered a permanent implant. Its purpose is to reinforce the repaired hernia in a permanent manner. On the other hand, an absorbable mesh weakens and deteriorates over time and is not meant to provide long-lasting reinforcement. Instead, it is designed to degrade and encourage new tissue growth that will eventually provide strength to the repaired area.

Most hernia surgeries are successful, but there is a possibility that a hernia may recur months or years after the initial surgery. When this happens in the vicinity or at the same spot as the previous repair, it is referred to as a recurrent hernia.

Removal of hernia mesh, which may be necessary due to issues such as mesh migration, infection, pain, or failure, is a complex procedure requiring a highly experienced and skilled surgeon. Hernia mesh is designed to become incorporated into human tissue. Therefore mesh removal requires a delicate technique of complete removal without damaging the native tissue. When mesh is successfully removed, any symptoms attributed to the mesh is usually alleviated. When mesh is removed, the surgeon also has to repair the remaining hernia with a sewing technique.

Hernias will not improve or heal with exercise. The only solution is surgical repair.