Hernia Clinic Hampshire Improves Post Hernia Surgery Results

Lowering the risks of recurrence using

Quality Hernia Meshes

Frequently Asked Questions About Hernia Meshes

Answered by Consultant Surgeon James Kirkby-Bott

A close up of ProGrip mesh showing the resorbable microgrips.

into the tissue, providing an alternative to traditional mesh fixation complications. It provides a true tension free repair without the risk of nerve entrapment through traditional fixation methods.”

Q: How is it fixed in place and can it migrate away from where it is supposed to be?

A: This depends on the mesh. Progrip is designed to be used without any other fixation, but we do tend to put in 2-3 loose dissolving sutures at the critical anchor points to be certain it won’t move.

In laparoscopic repairs we often do not fix the mesh as the fixation is a contributor to pain and chronic discomfort. However, this makes recurrence more likely and all the recurrences we have seen have been using a laparoscopic technique and no fixation of the mesh. We have recently started using a new glue to fix these meshes to minimise risk of chronic discomfort and recurrence.

Mesh does move – all the materials shrink in size by an area of around 20%. It is rare for mesh to migrate, but not unheard of.

Q: Is mesh permanent or does it dissolve?

A: Most meshes don’t dissolve, and meshes that do dissolve have higher hernia recurrence rates of around 10%. There is a new kind of mesh that does not fit into either group – this is the mesh that we use.

It is composed of 2 materials: A non-dissolving sheet that allows a scaffold for good embedding of new connective tissue, and a dissolving layer of little fasteners that embed into the posterior wall of the inguinal canal spreading any tension in the repair evenly over the 12×8 cm area of the mesh.

If these fasteners cause discomfort in the muscle, they dissolve from 6 months so they cannot cause chronic pain or discomfort. This mesh is called ‘Progrip’.

Q: Can you feel the mesh/can it cause pain?

A: We don’t expect the mesh itself to be felt, but you can feel the new scar tissue and inflammation around the mesh from your repair. This can persist for just over 12 months. Some people notice the inflammation initially as a ridge under the scar. This then flattens over 2 – 3 months, but can feel stiffer than the other side for up to 1 year. You can perhaps feel an uneven edge if it catches on tissue, but this is rare.

Chronic pain tends to come from the fixation used rather than the mesh itself. A mesh placed and fixed without tension is the most comfortable – this is why we use the ‘Progrip’ mesh and, in laparoscopic surgery, a moulded mesh that moves less.

Q: Do you have to do anything to maintain the mesh?

A: No, there is nothing you can do to influence the mesh. You can, however, influence the wound healing. It is wound healing rather than fixation that causes the most long term discomfort. You do have some control over this and we advice how to best recover from hernia surgery.

Other mesh used by Hernia Clinic Hampshire

Symbotex™ Composite Mesh, used in large incisional/ventral hernia repairs.