Hernia mesh is a medical device used in surgical repair to provide support to weakened tissue and encourage new growth. A common concern after hernia repair is the possibility of the implanted mesh shifting from its original position. This article explores how mesh is typically secured, factors that can contribute to its movement, how to recognize potential issues, and what steps are taken if movement occurs.
How Hernia Mesh Stays in Place
Surgeons typically secure hernia mesh using sutures, staples, or specialized tacks to the surrounding healthy tissue. This initial mechanical fixation provides immediate stability, holding the mesh in its desired anatomical location. The method of fixation depends on the specific hernia type, surgical approach, and the surgeon’s preference.
Over time, the body’s natural healing process plays a significant role in further stabilizing the mesh. As the body recovers, new tissue grows into and around the mesh material, a process known as tissue ingrowth. This biological fixation helps to anchor the mesh more firmly, creating a reinforced repair.
Reasons Mesh May Shift
Initial surgical technique is a contributing factor to mesh movement. If the mesh is not adequately secured with enough fixation points or if points are placed in suboptimal tissue, it is more likely to shift. Insufficient overlap of the mesh beyond the hernia defect’s edges can also increase the risk of dislodgement, as it may lack sufficient healthy tissue for integration.
The type of mesh material itself can influence its stability. Heavier, more rigid meshes might be less prone to folding but could cause more discomfort or erosion. Lightweight, flexible meshes may conform better to anatomical contours but may be more susceptible to crumpling or migration if not properly secured.
Patient factors also play a considerable role in mesh stability. Engaging in excessive physical activity or heavy lifting too soon after surgery can place undue stress on the repair site before full tissue integration. Conditions that increase intra-abdominal pressure, such as chronic coughing, straining during bowel movements, or obesity, can also lead to mesh displacement.
Inflammation or infection at the surgical site can compromise the integrity of the tissue surrounding the mesh. This can hinder proper tissue ingrowth. Poor tissue quality, often seen in elderly patients or those with certain medical conditions, can also make mesh securement challenging.
Recognizing Potential Mesh Movement
New or worsening pain at the site of the hernia repair can signal a potential issue with mesh position. This pain might be localized or radiate to other areas, depending on what structures the mesh might be affecting. A new bulging or palpable lump near the surgical area may also indicate mesh dislodgement or crumpling.
Discomfort that intensifies with movement, bending, or specific activities could also suggest a change in the mesh’s location. If the mesh shifts and presses on nearby nerves, numbness, tingling, or burning sensations may occur. In rare cases, if the mesh migrates significantly and contacts the bowel, symptoms like abdominal pain, nausea, vomiting, or changes in bowel habits could arise.
Signs of infection, such as fever, persistent redness, swelling, or warmth around the surgical site, can sometimes accompany mesh-related complications. These symptoms indicate a need for medical evaluation, as infection can weaken the tissue’s ability to hold the mesh in place. Any unexpected changes or discomfort after hernia repair warrant medical consultation.
What Happens When Mesh Moves
If mesh movement is suspected, healthcare providers conduct a physical examination. Imaging studies, such as ultrasound or CT scans, are often utilized to visualize mesh position and identify complications like migration, crumpling, or pressure on surrounding structures.
Management depends on symptom severity and displacement extent. For mild, non-debilitating symptoms, observation and pain management with medication might be recommended. This allows monitoring for symptom resolution or worsening.
For severe symptoms or confirmed complications, surgical intervention may be necessary. This could involve removing the displaced mesh, repositioning it, or replacing it with new mesh. Surgical revision decisions are made case-by-case, considering patient health and the specific issue.