Last Updated November 4, 2020
Surgical mesh devices used to repair hernias have been available for over a century in the United States and hernia repair is one of the most common surgical procedures performed today. In fact, more than 80% of hernia repairs performed in the U.S. use mesh, and, at the moment, there are more than 70 types of meshes commercially available.
It goes without saying that the hernia mesh industry is both profitable and competitive and manufacturers are incentivized to bring as many “new and improved” products to market as soon as possible. Most new hernia mesh brands are pushed through the U.S. Food and Drug Administration’s (FDA) 510(k) clearance or “fast track” process with little testing or laboratory review. Accordingly, hernia mesh devices sometimes present serious medical issues and complications for the patients into whom they are implanted.
Hernia Mesh Adhesion
Adhesions are bands of fibrous scar tissue that sometimes form following abdominal surgery. In some instances, these scars will form tissue that “sticks” or binds together inside of the body. Adhesions make normally slippery internal tissues collect together and can pull on small or large intestines causing intense pain. This condition can also form in people who develop peritonitis, an infection that spreads to the membrane covering the abdominal organs.
In cases where adhesive tissue becomes severe, bowel obstruction can result and cause cramp-like pains as well as other symptoms such as:
- Abdominal pain
- Nausea and vomiting
- Abdominal swelling
- Inability to pass gas and/or infrequent bowel movements
- Dehydration (dry skin, severe thirst, infrequent urination, swollen/dry tongue)
In cases where adhesive bowel obstruction is partial, surgery may be avoided with rehydration and insertion of a small suction tube through the nose into the stomach to prevent additional bloating. Complete bowel obstruction caused by adhesion often requires surgery to restore blood flow.
Hernia Mesh Contraction
Mesh contraction (sometimes referred to as “mesh shrinkage”) is a phenomenon that, when it occurs, usually does so within two months of being implanted in the body. It is usually characterized by a failure of the implanted mesh to adequately meld with surrounding tissue which results in the mesh no longer covering the hernia location. This often leads to the recurrence of the hernia and further surgery to retrieve the defective mesh and repair the hernia.
Hernia Mesh Migration
Mesh migration occurs when a surgically implanted mesh (typically through laparoscopic implantation) fails to adequately adhere to surrounding tissue and begins to move freely through organ cavities in the abdomen. Migration can result in serious complications for patients, such as erosion into viscous. As a consequence of erosion due to migration, infections and abscesses can form. If treatment for migration and erosion into the bowels is required, it can involve additional procedures such as laparotomy; bowel resection; mesh resection/removal, or anastomosis; followed by another procedure to repair the original hernia.
Hernia Mesh Fistula
Abdominal fistulas can form when a defective hernia mesh fails to properly adhere to surrounding tissue or “erodes” into the gastrointestinal tract. The mesh can cause an abnormal connection between internal organs and the intestines creating fluid leakage into body cavities (or even through the skin). Depending upon the location of the leakage, fistulas may cause diarrhea or poor absorption of nutrients and dehydration. Other fistulas may manifest no symptoms at all and even close on their own after a few weeks or months.
Physicians will ordinarily seek to locate a fistula using barium tracers, CT scans, and fistulograms to closely examine the stomach, bowels, or other areas of the abdomen. Treatment for fistulas may involve antibiotics; immunosuppressants; surgery or intravenous nutritional supplements.
Bowel Perforation Following Hernia Mesh Implantation
Hernia mesh migration and/or erosion can sometimes result in direct trauma to the bowels in the abdomen known as “perforation”. A perforation is a hole that can develop anywhere in your gastrointestinal tract between your throat and your rectum. When that hole or puncture occurs on your large intestine, it is a “bowel perforation”. A perforated bowel can cause the contents of the bowel to spill into your abdomen resulting in an infection known as peritonitis and eventually a more deadly condition known as “sepsis”. Common signs of a perforated bowel are:
- Severe stomach pain
- Chills
- Fever
- Nausea
- Vomiting
Bowel perforations are considered a medical emergency and physicians will seek to treat them immediately by first running X-rays and bloodwork to determine if an infection has developed. Next surgeons will work to repair the perforation. In some cases, the surgeon will perform an ileostomy or colostomy to empty the contents of the bowel while allowing the tissue to heal.
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Tracy Everhart
Tracy Everhart is the Editor for Drug Law Journal. A highly-trained and certified medical professional, Tracy is also an accomplished medical writer. After spending years on the front lines of the medical profession, Tracy now devotes her expertise and skills to researching and reporting on new drugs and devices that enter the market, as well as their side-effects and the real-life stories involved. Prior to joining Drug Law Journal, Tracy wrote for benchmark online healthcare resources focused on families and, in particular, women’s health issues. Tracy holds post-graduate degrees from both the American College of Healthcare Sciences and the Yale School of Nursing. She is also a graduate of both Hampshire College, where she studied microbiology and the University of South Carolina school of nursing.
