In the United States, the application of mesh in ventral, incisional, and inguinal hernia repairs is the standard part of the treatment. Recurrence of hernia takes place if the hernia mesh ruptures or tears. It causes the occurrence of symptoms similar to the hernia symptoms that required repair surgery initially. There are various reports that reveal that hernia mesh might have complications if it is torn or ruptured.
What Is Hernia Mesh?
Mesh placement is usually regarded as the standard procedure in ventral hernia repair. The common complications of ventral hernia repair include infection and rupture of the hernia mesh. Hernia mesh also called surgical mesh, is a medical device that supports damaged tissue around a hernia during its healing period.
Hernia surgery involves the placement of the hernia mesh around the damaged area in the abdomen, upper stomach, or groin, which is placed in position with the help of sutures. The mesh pores help the tissue grow into it, provide support and repair the muscle tissue.
Usually, there is a risk of recurrence after hernia surgery. Hernia mesh helps to strengthen the region around the hernia and reduces the rate of recurrence. The recurrence rate of hernia is reduced by up to 50 percent when using mesh. Various studies have shown that a lower recurrence rate is observed using mesh compared to hernia repair without mesh. Therefore, the use of mesh helps to achieve a better prognosis.
How Does Hernia Mesh Ruptures?
A hernia is seen as a result of a problem in the internal tissue that leads to the development of a hole that causes an internal organ to stick out or protrude through the hole. The hole is most commonly seen in the abdominal wall, and the protruding organ is the intestine. During surgery, a hernia mesh patch is used to close the hole in the abdominal wall. Further, the patch provides support to the surrounding tissues in the abdominal wall. The hernia mesh can rupture or tear due to the following reasons:
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Erosion of hernia mesh.
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Hernia mesh is made of weak materials.
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The mesh is not secured at its place adequately by the surgeon.
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Shrinking or expansion of the mesh.
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Adherence of the mesh to other tissues or organs.
What Are the Symptoms of Hernia Mesh Rupture?
In case of hernia mesh repair rupture, the following symptoms are experienced:
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Chronic abdominal pain.
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Swelling and bulging at the site of surgery.
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Lack of healing at the incision site.
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Wrinkled mesh under the skin.
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Signs of infection (fever and nausea).
While these symptoms might also indicate serious complications like adhesion of the mesh, mesh migration, infection, and bowel obstruction or perforation.
How Is Ruptured Hernia Mesh Diagnosed?
The patient must consult the doctor if they experience any of the above-mentioned symptoms without any known cause or have had hernia repair surgery in the past. Diagnosis is usually difficult. Imaging techniques like X-rays or a computed tomography (CT) scan might be performed to identify the underlying cause of the symptoms experienced by the patient due to the hernia mesh implant.
How Is Ruptured Hernia Mesh Managed?
If the hernia mesh is torn or ripped, it might result in serious complications that cannot be managed with medication; removal of the hernia mesh is needed. However, the removal of the mesh is a critical decision that has both benefits and risks for the patient. In most cases, there is no relief seen in the symptoms unless the defective mesh is removed.
Who Must Undergo Hernia Mesh Removal Surgery?
The mesh removal surgery is performed after proper consideration and discussion between the surgeon and the patient regarding the risks and benefits. The following patients are eligible for undergoing mesh removal surgery:
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Patients experiencing severe, long-lasting pain that cannot be treated with medication.
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A life-threatening infection that shows no improvement with antibiotics.
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A patient with a recurrent hernia.
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A patient whose hernia mesh has undergone erosion or adhesion to other organs.
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Pain or other complications caused by organ perforation.
What Is the Procedure for Hernia Mesh Removal?
An additional surgery has to be performed in case of a hernia mesh rupture. An invasive surgery is required to remove the ruptured or defective product. Incisions are made into the skin and tissue around the patch to remove the mesh. The mesh is removed by cutting the sutures that connected the mesh to the abdominal wall that was causing pain. Just like any other surgery, the removal of the mesh requires time to heal. The patients are usually advised to take adequate rest, avoid any physical activity, and follow the instructions given by the doctor.
During the surgery for hernia mesh removal, the doctor might also have to repair any other damage caused by the defective product, including sealing puncture wounds and repairing damaged nerves or blood vessels.
The benefits of ruptured hernia mesh removal must not be ignored while calculating the risks. The mesh removal surgery can have a positive effect on the health and life of the patient as it can relieve the long-term complications and pain experienced by the patient.The main issue with mesh rupture is that when the implant tears or rips, it usually migrates to the surrounding area or is eroded. There can be further damage caused in these situations. Mesh removal surgery is needed to reduce the amount of injury. It also helps to repair and treat the injuries already caused by the torn mesh.
Conclusion
Hernia mesh rupture or any other hernia patch complication might require revision surgery by the doctor. The majority of the cases involve surgery to attempt to remove the old mesh patch and repair the hernia again. However, this procedure is more invasive than the initial hernia repair surgery and is usually less successful. It is extremely difficult or complicated to remove the ruptured hernia mesh and requires great expertise, therefore, the mesh used in this procedure must be of good quality, and the doctor should inform the patient about the consequences prior to the surgery.
