What Is Surgical Mesh?
What Is Surgical Mesh?
Surgical mesh is a flexible sheet made of plastic or organic materials. Many meshes have a medium-fine weave that encourages tissues to grow into it while others are solid sheets. It is used to reinforce and repair weak tissue due to surgery, pregnancy, childbirth, and even exercise. Most hernia repairs use mesh.
What Is Mesh Made Of?
- Polypropylene is a plastic-like substance that is woven to make mesh. Polypropylene has many applications, including everyday items. The lid of a Tic Tac container is made of this substance. You may have sat on chairs made of it. In surgery it is commonly used as mesh. Many different hernia repairs can be accomplished using this plastic mesh. It is a soft, supple material that is not absorbed by the body.
- Polyglycolic acid and polycaprolactone are two more plastic-type materials used to make surgical mesh. These materials are also made into sutures (the needle and thread surgeons use). Mesh made of these materials can be absorbed by the body.
- Organic materials, most usually porcine (pig) or bovine (cow), are also made into surgical mesh. The tissues used are processed to make them safe for human bodies. Mesh made of organic materials is absorbable. Over time the body will break it down and absorb it.
- Composite mesh is made of organic and inorganic materials used together. It is both absorbable and nonabsorbable by the body.
Use for Hernia Repairs
Surgical mesh has many applications. Hernias of all types are repaired using mesh. The ones used for hernia repairs may be nonabsorbable, absorbable, or a composite. There are many different types of hernias:
- Inguinal: groin area, lump that comes and goes
- Femoral: upper thigh to groin, lump that comes and goes
- Incisional: the site of a surgical incision, lump that comes and goes
- Ventral: somewhere on the abdomen, may be many, small to larger lumps that come and go
- Umbilical: belly button, turns innies to outies
- Hiatal: Inside the abdomen, causes heartburn
Hernias may cause pain at the site. Hernias usually have lumps that come and go. These lumps are the bowels pushing their way out of the abdominal cavity. The problem is part of the bowel can get trapped outside of the abdominal cavity. Nothing can flow through the trapped part. This problem requires emergency surgery.
Surgical Mesh Can Repair Hiatal Hernias
Hiatal hernias are different. This type occurs when the stomach bulges through the diaphragm into the chest cavity. Mesh may be used to reinforce the opening in the diaphragm so the stomach can no longer bulge through.
Use for Pelvic Floor Repair
Stress urinary incontinence caused by pelvic organ prolapse can be repaired using surgical mesh. This repair is to strengthen muscles that have grown weaker due to pregnancy, childbirth, or aging. The mesh used for this repair will be non-absorbable.
What Are the Risks of Using Surgical Mesh?
- Foreign body reaction causes inflammation and slow healing to occur. This inflammation can be acute (short term) or chronic (long term). Occasionally, the mesh will need to be removed surgically.
- Seroma formation is another risk of using mesh. A seroma is an area that becomes filled with a yellowish-clear fluid, much like the fluid from a blister. This may or may not resolve itself naturally. Usually, the body will reabsorb the seroma fluid.
- Any foreign body can increase the risk of infection. Surgical mesh is no exception. At times bacteria can grow at the site of the mesh, causing infection with its associated inflammation and pain.
- Surgical mesh can also cause adhesions. This happens when tissues stick to the mesh or other tissues. Adhesions are usually painless. When pain occurs there is a problem. Adhesions to mesh most commonly occurs in the abdominal cavity. Parts of the bowel may stick to the mesh, or they may stick to each other. Sometimes adhesions may cause a bowel obstruction. This requires surgery to fix.
- Mesh rarely causes a fistula to form. A fistula is an abnormal passage way between two organs or blood vessels. The most common type of fistula is man made. This is the fistula between an artery and a vein used for dialysis. Fistulas require surgery to fix.
Abdominal mesh should not be used in patients who may experience growth. Children, women who may become pregnant, and infants may encounter problems due to the mesh not being able to stretch.
Animation Showing Umbilical Hernia Repair With Mesh
Regarding the Video
In the video above you will notice the mesh was woven on one side and solid and shiny on the other. The one side is woven to encourage tissue growth into it. The other side is solid so that tissue will not grow into it. Whenever mesh is placed within the abdominal cavity it will have one side that is non-stick to prevent the bowel from sticking and causing an adhesion or fistula.
What Can You Do After Surgery to Help Healing
- It is important to follow your doctor's instructions regarding activity. If you resume activities too soon you may pull the repair apart. This will require having it redone in another surgery.
- Do not strain or stress the area of mesh repair. Your surgeon will tell you how long your restrictions will be. For one thing, you cannot lift anything heavier than a gallon of milk. If you have a desk job you will usually be able to return to work within a week. However, if your job requires lifting heavy objects, it may be six weeks before you can go back to work. Always check with your surgeon before doing anything strenuous.
- Walking is a good form of exercise to perform while you are healing. Walking speeds the healing process by increasing blood circulation. Your blood is responsible for bringing the healing cells and taking away the waste.
- Strenuous exercises such as weight lifting cannot be done for up to six weeks. Again, your surgeon will tell you when it is safe for you to resume this regular activity.
- If you have children, sit down and let them climb into your lap. You do not want to lift anything heavier than 10 pounds. Children do not understand your inability to lift them, but spending time with them in your lap helps them to feel loved.
- Do not drive until your surgeon says you can. Various hernia repairs can interfere with driving. You will not be able to abruptly use the brakes without disrupting the repair.
Should I Agree To Surgical Mesh?
Having surgical mesh implanted does carry some risk. However, these problems do not occur very often. Many, many people have mesh implanted and very few experience a problem. Your surgeon can tell you how often these risks happen. I, personally, would agree to using surgical mesh. Remember though, we are all different. Always ask your surgeon any specific questions you have. Your surgeon will know what is best for you based on your health history.
Questions & Answers
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