Surgical Mesh

What is surgical mesh?

Surgical mesh is a screen-like material that reinforces weakened or damaged tissue, usually in your abdomen (belly) or groin. It’s typically human-made (synthetic) but can also come from animal tissue. A surgeon inserts the mesh after making a cut (incision) in your body. As your body heals, tissue grows into the mesh — think of how a tree can grow into a chain-link fence or how cement fills in around rebar — and makes it stronger.

Other names for surgical mesh include:

• Abdominal mesh
• Hernia mesh

What is surgical mesh used for?

Healthcare providers may recommend surgical mesh to treat a hernia. A hernia is when an organ or tissue pushes through a weak area in your muscle or tissue walls. Surgeons can sew these weakened areas closed. But often, the tissues will slowly come apart again due to wear and tear. Surgical mesh can help strengthen the closure so that the weakened muscle stays together.

What is surgical mesh made of?

Surgical mesh can consist of synthetic polymers or biopolymers. Synthetic polymers are human-made and come from petroleum oil. Biopolymers come from the cells of living organisms.

The materials may include:

• Absorbable synthetic polymers (polyglycolic acid or polycaprolactone)
• Biologic (acellular collagen from cows or pigs)
• Composite (a combination of any of the three materials)
• Non-absorbable synthetic polymers (polypropylene) — most common

The mesh comes in different forms: knitted or woven.

Knitted surgical mesh is one long thread that continuously loops around itself. It looks similar to a knit sweater. Knit mesh is more flexible and porous — it allows a lot of tissue to grow into the material.

Woven surgical mesh has interlaced threads that criss-cross over and under each other, up and down and side to side. It looks like a chessboard and acts like the steel bars that reinforce concrete in buildings and roads. Woven mesh has more consistent mechanical properties — each square in the mesh can handle stretching and pressure the same.

How long does surgical mesh last?

Non-absorbable mesh permanently strengthens and reinforces your muscle or tissue. Absorbable mesh isn’t permanent. Your body slowly takes it in and replaces it with new tissue or muscle over time.

Each mesh has advantages and disadvantages. A surgeon will explain the pros and cons of each type and answer any questions you have.

How does a surgeon implant surgical mesh?

It depends on the type of hernia repair surgery you need. But in general, a surgeon will:

1. Make one single cut (incision) that’s several inches long if you have open surgery, or several smaller cuts if you’re having laparoscopic surgery or robotic surgery
2. Put the herniated tissue back where it belongs and use sutures (stitches) to stitch the weakened area of muscle closed
3. Place the surgical mesh below, between, or on top of the muscle to help strengthen the repair
4. Close the incision(s) with sutures

Where is surgical mesh placed?

It depends on where your hernia is and its severity. A surgeon may place surgical mesh:

• Between your intestines and abdominal wall
• Between the muscle layers in your abdominal wall
• On the outside of your abdominal wall

They’ll explain where they’ll place the mesh during a pre-surgery consultation.

What are the potential benefits and risks of surgical mesh?

The primary benefit of surgical mesh is that it’s generally a safe, effective and common hernia treatment. It’s also less likely that a hernia will come back.

Surgical mesh risks include:

• Infection
• Non-absorbable synthetic surgical mesh can break and allow the muscles to come apart again (hernia recurrence)
• Rarely, mesh placed near organs can erode into other organs like the intestines or urinary bladder
• The mesh doesn’t grow into your muscle tissue

These risks are low. But like all medical procedures, you and your healthcare providers will discuss the risks of an operation against not having surgery or not using mesh. In most cases, the surgeon chooses to fix the hernia and uses mesh when the risk of not fixing the hernia and not placing mesh leaves you at a greater risk. For example, a hernia can lead to bowel obstruction, bowel strangulation (the blood supply to your bowels is cut off) and emergency surgery if left alone. That said, most people have a provider fix their hernia because it causes pain and limits their quality of life.

Other general surgery risks include:

• Anesthesia problems
• Excessive bleeding
• Long-term (chronic) numbness or pain in the area, possibly from nerve damage

How long will it take for me to feel better?

It depends on the type and severity of your hernia and what type of surgery you need. But in general, you should be able to return to work or school after about a week. You may need to take more time off if you have a more physically demanding job, or if your hernia is large. Your surgeon will discuss this with you at your appointment.

You can engage in light exercise, like walking, as much as you can tolerate a day after surgery. Wait at least two weeks to run, ride a bike or swim. Don’t engage in high-impact exercises, like sprinting, sports or weightlifting, for at least a few months.

Is there anything I can do to make surgical mesh easier on me?

After receiving surgical mesh, you can help make your recovery easier by:

• Avoiding straining when using the bathroom
• Drinking plenty of fluids, especially water
• Taking pain medications as prescribed by your healthcare provider
• Walking each day, which helps improve your blood flow and makes it easier to poop and pee

When should I call my healthcare provider?

After receiving surgical mesh, reach out to a healthcare provider if you have:

• Severe pain
• Signs of infection, such as discoloration (red, purple, brown or black), fever or yellow drainage from your incision
• Signs of irritable bowel syndrome, including constipation, diarrhea, gas and bloating