Hernia Recurrence after Mesh Repair | 1 in 6 Need 2nd Surgery

Hernia recurrence is all too common considering that hernia repair is known to be one of the commonly practiced surgical methods. One in six patients implanted with hernia mesh and undergoing a ventral and incisional hernia repair (VHR) will suffer a hernia recurrence and require a 2nd surgery within 10 years of the initial implant. Surgery News  “Additionally, multiple follow-up operations are common, with nearly 20% of patients requiring two or three reoperations.” Id.  “Hernia recurrence can be a devastating outcome, and it has been associated with poor quality of life, functional disability, chronic pain and increased risk for life-threatening complications.” Id.

hernia recurrence

The different causes of the recurrence can be identified by experts in order to find the best solutions needed to treat it. Prevention and elimination can be done for the sake of resolving hernia recurrence. Various studies and articles have been analyzed for the sake of improving the research when it comes to recurrence treatment to ensure a better condition on a patient’s hernia. As a result, the causes of recurrence have been analyzed based on the results of the surgeries done for hernia mesh repair.

Even surgeons know well that this is one of the most common operations that occur in hospitals. Due to the commonness of the procedure, various types of operations have been offered in many hospitals around the world as long as hernia repair is concerned. There are procedures such as open and laparoscopic treatments for those who wish to undergo this type of surgery. However, the type of surgery that can be done to patients will depend on the recurrence rate after the said operation.

Hernia  recurrence problems years later

The success rate of the hernia repair is often observed depending on the operation if it can provide a permanent result if complications will lessen, the timeframe needed for the patient to rest before they can resume their normal activities, as well as the minimal costs of the surgery. But despite all these factors, doctors often view the risk of recurrence as the primary factor when viewing the success rate of hernia repair. A 15% recurrence rate using primary hernia repair was often done before applying the hernia mesh. But despite the usage of the very versatile mesh implants, recurrence rates on the hernia still tend to exist. The main factors vary upon the type of repair done.

Gladly, hernia mesh was used and being developed to ensure a better recurrence rate for patients and surgeons. These meshes are often made with a porous material that allows the growth of damaged tissues. The material is also known to be reactive in order to promote ingrowth within the tissue while preventing any type of negative reaction such as inflammation and allergies. The mesh is also known to be durable enough to provide full protection to the groin, and it lessens the risk of recurrence further.

Factors in Hernia Repair That Affects Recurrence Rates

During an open repair, early recurrences occur due to the issues have done during the operational processes that are done to the patient. This also includes postoperative infections that are considered as the most common cause of the recurrence after operation. There are late recurrences that may occur to the patient such as the defect of the patient’s collagen. Age can also be a leading factor towards the recurrence of a hernia, wherein older patients may experience it often. Medical morbidities are also observed oftentimes in order to determine hernia recurrence as well.

On the other hand, laparoscopic repair can decide the risk of hernia recurrence as well. But there are fewer factors that may cause the condition to happen. Mesh placement is the most common cause that may happen after the repair. Other problems include dissection and fixation, and these are often observed in order to view if it’s causing the hernia recurrence. These can also happen as either early or late recurrence to the patient.

That’s why numerous researches in regards with hernia mesh usage for hernia recurrence were developed in a way where the researchers often base previous hernia repairs, as well as the numerous articles made by experts to ensure full knowledge and development over the surgery’s improvement. This is also done for the sake of understanding hernia surgery in all aspects, which also include the problems that it may cause.

Recurrence Statistics

An article from Science Direct states that surveys were conducted for the sake of observing recurrence incidents following a hernia repair to a patient. The surveys showed that specialized hospitals and other centers tend to have a recurrence rate of 1%, while general hospitals got a result of 30%. This is great news to the field of medicine when it comes to the usage of mesh. The article also states that 10 – 30% recurrence rates are present during the time when mesh wasn’t introduced to hospitals. What’s alarming was the 35% recurrent hernia repairs to the patients as well.

This just shows how extremely important a hernia mesh treatment is needed nowadays if a patient wishes to attain a higher success rate for their surgery. This is a right that all patients must have, and this must be promoted further in hospitals for the sake of decreasing recurrence rates, which can be a huge problem to most patients especially when it comes to their time and finances.

Hernia recurrence after hernia mesh repair is a known complication that can occur in some cases. Hernias occur when an organ or tissue pushes through a weak spot in the surrounding muscle or connective tissue. Surgical repair is often necessary, and hernia mesh is commonly used to reinforce the weakened area and reduce the risk of recurrence.

However, even with mesh repair, hernias can sometimes recur. The factors contributing to hernia recurrence after mesh repair include:

1. Mesh-related factors:
   • Mesh type: The choice of mesh material and design can influence the risk of recurrence. Some meshes may be more prone to complications or failure than others.
   • Mesh size: The size of the mesh used and its coverage of the hernia defect can affect the success of the repair.
   • Mesh fixation: The method used to secure the mesh in place can impact the likelihood of recurrence. Inadequate fixation or improper placement may contribute to failure.
2. Patient-related factors:
   • Patient’s overall health: Chronic illnesses, obesity, smoking, and other health factors can affect the body’s ability to heal and increase the risk of complications.
   • Infection: Postoperative infections can compromise the success of the surgery and contribute to recurrence.
   • Poor tissue quality: Some patients may have weaker tissues that are more prone to hernia recurrence.
3. Surgical technique:
   • Skill of the surgeon: The experience and skill of the surgeon performing the hernia repair can influence the outcome.
   • Inadequate tissue overlap: If the mesh does not sufficiently overlap the hernia defect, there is a higher risk of recurrence.
4. Postoperative care:
   • Activity restrictions: Failure to follow postoperative activity restrictions can strain the surgical site and contribute to recurrence.
   • Failure to address complications: Prompt identification and management of postoperative complications, such as infections, are crucial to prevent recurrence.

It’s important for patients to follow their surgeon’s instructions for postoperative care and attend follow-up appointments to monitor for any signs of complications. If a hernia does recur, further surgical intervention may be necessary.

Individual cases can vary, and the decision on the type of hernia repair and mesh used should be made in consultation with a qualified surgeon who can assess the specific characteristics of the hernia and the patient’s overall health.

REFERENCES:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1190751/

https://www.sciencedirect.com/science/article/pii/S1743919113000873